Skip to main content

When your members make better choices, everyone benefits.

We’re helping health plans across the country help their members make better choices. We are doing this across virtually every line of business (commercial, Medicare, and Medicaid). See health plan clients just like you realizing some pretty amazing results.

Commercial Success Stories

National Commercial Plan

Creating member “nudges” toward virtual care alternatives, Softheon and its’ payer partnership increased telehealth usage, ultimately reducing av…

View Case Study

Regional Blue Plan

Ability to measure clinical programs with efficiency and accuracy to drive cost-saving insights.

View Case Study

Regional Blue Plan

Ability to measure clinical ER visits declined by 8.1% and costs by $8 PMPM; Avoidable ER visits decreased by 5.1% and $0.35 PMPM.

View Case Study

Regional Blue Plan

an 8x increase in clinical portfolio evaluation assesses more than 50 programs focused on Total Cost of Care and identifies 15 programs with statis…

View Case Study

Medicare Success Stories

Regional Blue Plan

Softheon helped spark shift in Care Manager scripts and deployed an MSK predictive model to steer members to in-network physicians and to Blue Di…

View Case Study

Medicare Advantage

Health plan sees gap closures per member per year leading to better quality as reflected in STARs rating.

View Case Study

Medicare Advantage

Better member choices result in an 8.7% reduction in ER visits yielding a $9 PMPM savings.

View Case Study

National Commercial Plan

Health plan helps behavioral health members make better choices leading to a 33% increase in diabetes programs, a 55% increase in behavioral app pr…

View Case Study

Medicaid Success Stories

National Medicaid

Health plan sees fewer pre-term deliveries and low birth weight babies through program participation.

View Case Study

Regional Medicaid

See how this Medicaid plan realized a 25 percent reduction in ER visits and a 39% ED cost reduction for a predicted high utilizer population.

View Case Study

Regional Medicaid

See how this health plan realized a 6.3% reduction in ER visits and experienced a $6 PMPM reduction through better member outreach.

View Case Study

Find Out More

Bring us your use case and we’ll use our solutions to influence your members towards better choices—choices that help improve their lives and your financial performance.

Get Started