Humana was looking for a way to enhance access to specialists and improve clinical outcomes across their provider network with a digital solution. Typically, coordinating referrals across a disparate provider network has many challenges: long delays between referral order and actual appointment, identifying appropriate specialists, inefficient appointment coordination and scheduling, and inability to track data in real time.

These challenges lead to poor patient experience, diminished access to care, wasted time, negative clinical outcomes, and increased medical costs.

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Pay-for-performance incentives are impacting health plans’ bottom lines. To maximize these incentives, health plans need to improve quality scores by closing more gaps in care. Population health vendors have come a long way in identifying those gaps and then taking action to close them, but often times it all falls apart on the last step.

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