Best in class solutions

Our reporting platform enables a higher level of strategic client consultation and better decision-making overall through: 

• Tailored benchmarking for cost, quality and utilization comparable by region, state, MSA and industry

• The ability to uncover key trends and opportunities for improvement by state, MSA and more using market-level data

• Real-time data integration, instant access to self-service analytics and faster downloading

• User-friendly reporting tools with rich data visualizations

Celeste is a first-of-its-kind health solution that integrates payor, navigator and point solutions better than anything on the market. Connecting the entire, end-to-end member experience, it’s the perfect complement to Skai with: 

• Navigation and advocacy—guiding members to the right solutions at the right time

• Smart engagement and personalized care plans—based on data-driven member insights

• High-quality care—for better outcomes and lower costs

• Claims support—to lighten the administrative burden

• Point solutions—thoughtfully curated and optimized

• Decision support—helping members navigate the complexity

• Complex care management—for better outcomes on chronic high-cost conditions

• Benefits management—providing additional support for employers

Grounded in decades of industry expertise and cutting-edge technology, our health economics and data science division sharpens our ability to holistically understand members through: 

• Proactive identification that classifies members before they become high-risk or high-cost

• Care gap detection that predictively identifies the most impactful healthcare gaps, which is then used for high-risk member outreach

• Micro-population insights that determine where costs are derived and establish strategies to combat them

We specialize in providing best-in-class, holistic support to members when and how they need it through:

• Data-driven identification and outreach that targets the right members, in the right way, at the right time for increased engagement

• A comprehensive and integrated team of nurses, social workers, dieticians, physicians, pharmacists and non-clinical advocates

• A dedication to whole-person care that puts equal value on physical, mental and social needs to drive optimal clinical outcomes

We’ve tackled the complexity of managing costs for members and employers while also improving medical pharmacy experiences for everyone with:

• A dedicated review practice that comprehensively approaches new, innovative medications and therapies while also consistently reevaluating each medication’s clinical effectiveness

• Net cost and waste reduction with Synergie Medication Collective through volume-based contracting, value-based models and contracting efficiency

• Fewer treatment delays through a proactive and efficient prior authorization process

• Site-of-care optimization that ensures members receive quality care through convenient and cost-effective care access

• Comprehensive integrated support by pairing the member with a dedicated case manager who collaborates closely with Skai Blue Cross Pharmacy, medical and utilization teams

Our blend of rich health networks, established partnerships and propensity for innovation allows us to develop plan and network solutions that are one-of-a-kind including:

• Value-based care models that support downside risk

• Partnerships that drive members to high-quality, low-cost care

• Enhanced network curation and a multi-tiered network approach that drive unbeatable savings

• Comprehensive, advanced virtual care solutions

• Out-of-network advocacy that comprehensively protects members from surprise medical costs