Affinitē Care Management (CM)

Care Management for the Modern Health Payer

Unify data, analytics, and intelligent workflow automation to drive early, coordinated engagement across the care continuum.

Sophistication, ease-of-use, and designed with long-term innovation in mind

Today’s health plan must simultaneously execute its care management objectives, adapt to emerging requirements without disruption, and drive innovation across the organization.

Affinitē Care Management (CM) rises to meet this challenge. By driving seamless healthcare workflows and enabling early member engagement, it empowers health plans to intervene before risks escalate. As a next-generation population health solution, Affinitē CM leverages our powerful CareFlow™ Rules Engine and integrated artificial intelligence to deliver smarter, faster, and more coordinated care management.

It’s Time to Expect More From Your Care Management Platform

Unique Risk Stratification Capabilities

Unique identification and stratification rules preemptively identify member needs and present the most appropriate level of intervention.

Innovate Beyond Legacy Systems

Affinitē CM's cloud-native architecture, AI and embedded data science gives payers a platform that can integrate seamlessly with existing legacy systems, while providing a foundation for scalable, long-term innovation.

Clinicians Working at the Top of Their License

Built-in intelligence such as load-leveling with automatic assignment to care managers, licensure checks, prioritization, and throttling ensures clinicians are able to work at the top of their license.

Real-Time Insights on Member Needs

Analytics and predictive models are embedded into the solution - not in a separate report of application - for the ultimate in care management execution.

Intelligent Automation Across the Enterprise

Affinitē CM harnesses the power of our CareFlow™ rules engine to intelligently automate workflows, data fluidity, and next-step actions with both internal and external stakeholders.

Collaboration with Providers and Members

The power of real-time information sharing and timely member insights with the adoption of our native Provider Portal or Mobile Member app or connect seamlessly with API-driven integration to existing payer solutions.

NCQA Population Health Prevalidation

Vital Data Technology is honored to be NCQA Population Health Prevalidated, providing health plan executives with the confidence that our platform meets the highest standards of quality and effectiveness.

This recognition affirms our alignment with NCQA’s rigorous criteria across key accreditation programs, including:

Health Plan Accreditation
Case Management Accreditation
Population Health Program Accreditation
MBHO Accreditation

By working with a prevalidated partner, health plans can accelerate innovation, strreamline compliance, and advance measureable outcomes for the members they serve.

Powered by embedded CareFlow™ intelligent automation and integrated AI for end-to-end, risk-stratified care management that microtargets the right members at the right time for the right type of intervention.

Complete Data Activation

Aggregate and integrate a complete set of clinical and non-clinical information to gain insights into a patient’s health, including social determinants of health and other less conventional data sets.

Unique Automation Logic

Preemptively identifies members with rising risk and presents them with the recommended level of intervention.

Advanced Rules Engine

AI-driven CareFlow™ Rules engine automates workflow processes, thereby eliminating much of the work done previously in a manual fashion.

Embedded Risk Intelligence

Data science combines complex microtargeting, identification, and stratification using risk algorithms and quality metrics directly in the tool to prioritize and segment care interventions for members.

Member & Provider Engagement Integration

Native integration with optional ProviderPortal™ and MyVitalData™ mobile member app for real-time engagement and collaboration. Or integrate directly with the plan’s existing solutions.

360-Degree Member Views

Multi-dimensional member views provide quick visibility into the member’s services, providers, and medications and insights into risk, predicted costs, social determinant deficits, and utilization from our data science models.

Tangible Results

A large, national health plan wanted to identify high-risk members sooner, streamline referrals with intelligently automated assignments, increase the volume of cases being managed, and improve member engagement. After one year of implementing Affinitē Predictive Analytics, they saw the following results:

1 %

of probable high-risk members identified were not previously know to the plan.

1 x

increase in members touched in emerging high cost group.

1 x

increase in members successfully contacted in emerging high cost group.

1 x

increase in the number of cases referred to CM across groups.

1 %

decrease in the number of days to open a case

Affinitē Care Management (CM)