Baba for payors & plans.
Baba adds an engagement layer between a health plan and its members. Advocates call, find the provider, arrange the ride, and stay on the task until it is closed.
A sample advocate workday:
EED Eye exam for patients with diabetesFound a retinal clinic nearby, booked the exam, then lined up a ride.
Tasha
PDC-DR Medication adherence · diabetesCalled the pharmacy, switched to 90-day fills, and synced the pickup dates.
Miguel
FMC Follow-up after ED visitGot the PCP visit on the calendar for five days after the ER discharge.
Priya
- CBP Controlling high blood pressure
Had a home cuff delivered and put the blood-pressure recheck on the calendar.
Tasha
Baba is participating in the CMS ACCESS Model
What the research has found
The figures below come from studies of community health workers, chronic care management, transition coaching, and patient navigation.
- returned per $1 invested in community health worker support, among high-need patients
- $2.47
returned per $1 invested in community health worker support, among high-need patients
Health Affairs, 2020- lower Medicare spending per member per month in CMS’s evaluation of chronic care management
- $74
lower Medicare spending per member per month in CMS’s evaluation of chronic care management
CMS evaluation, 2017- fewer 30-day readmissions among older adults who received transition coaching
- 30%
fewer 30-day readmissions among older adults who received transition coaching
Archives of Internal Medicine, 2006- breast and colorectal screening completion with patient navigation, across 30+ trials
- 1.5×
breast and colorectal screening completion with patient navigation, across 30+ trials
J. General Internal Medicine, 2020
The work between the report and the result
5% of members account for ~50% of health spending. Advocates work on the practical problems that sit between a care plan and a completed visit.
Commonwealth Fund
After the hospital
The advocate gets the follow-up on the calendar, sends the discharge summary to the PCP, and checks the medication list while there is still time to prevent a return trip.
TRCMRPFMCPCR
Between refills
Ninety-day fills, pharmacy sync, mail order, and the prior-authorization call that still needs to be made. Adherence is logistics before it is behavior.
PDC-DRPDC-RASAPDC-STASUPD
Before the emergency room
When transport falls through or a benefit is unclear, an advocate fixes the immediate problem before the emergency room becomes the fallback.
ED utilizationCAHPS
Members with this kind of support had nearly twice the odds of rating their plan highly.
CAHPS is double-weighted. Members answer “getting needed care” from lived experience: whether someone helped them get the appointment, refill, or ride.
Talk with our health plan team
Tell us what you are evaluating. We will follow up to schedule a conversation.