Complex care delivery
Whole-person care for complex conditions
Traditional healthcare can be complicated and impersonal. That’s why we simplify access to compassionate care for complex and chronically ill patients — meeting them wherever they are in their healthcare journey to provide the right care, at the right time, and in the right setting. Our dedicated clinical teams form trusting relationships with members and often serve as the patient’s first call for urgent medical needs or concerns. Our program can improve engagement and treatment plan adherence, and help keep patients medically stable and healthy.
Through our Carelon Health business, we have 25+ years of experience delivering highly integrated, personalized care. Our advanced primary care model focuses on prevention, early intervention, and member well-being — making Carelon an ideal partner for health plans in value-based care and traditional payment structures. We are an industry leader in providing exceptional clinical outcomes proven to lower the cost of care, and nationally recognized for our specialized programs in diabetes, heart failure, chronic obstructive pulmonary disease (COPD), kidney disease, and more.
Exceptional results from the start
25+
years of experience
190K+
individuals served by Carelon Health
94%
of members report having a good experience with Healthy Start®
Once a pioneer, always a pioneer
As a pioneer in whole-person, value-based care, we have a successful history of full-risk capitation, risk sharing, and accountability for cost and outcomes.
With health plan experience and a deep understanding of managing complex populations, we use our agility, flexibility, and expertise to support a wide range of patient needs.
Whole-person care
A team-based care model that delivers integrated whole-person care to address all aspects of the patient’s needs in our care centers, at home, or virtually.
Personalized care
Individual care plans are developed through an initial assessment of needs during a Healthy Start™ visit, improving patient outcomes and satisfaction.
Full-population health
A whole-health care model that coordinates care for Medicare and Medicaid populations, whether they are healthy, at risk, or in need of additional care.
Commercial
Care programs to manage complex and chronic patients, improve outcomes, reduce cost of care, and decrease provider burden for improved retention.
Imagine a better connection to better health
From integrated data to integrated care teams, we know that strong connections are essential for providing health services to those with complex needs.
As a result of our approach, we improve health outcomes and experiences by:
- Reducing inpatient admissions and shortening length of stay.
- Preventing hospital readmissions.
- Decreasing the cost of care.
- Improving Healthcare Effectiveness Data and Information Set (HEDIS) scores and Centers for Medicare & Medicaid Services (CMS) Star Ratings.
- Providing convenient care at home, virtually, at our care centers, in mobile units, at skilled nursing facilities, or at hospitals.
Visit our Carelon Health site to learn more about how we’re making complex condition management easier for our patients.
See healthcare from our perspective
Our work gives us unique insight into how care can be delivered, integrated, and connected across the healthcare system. Here’s how we’re leading the conversation, now and in the future.
Connected care promotes systemwide efficiency, improves outcomes, and lowers costs. Explore 3 key approaches to place people at the center of care.
