Challenge: Hurricane
HEOPS was faced with a 30-day recontracting initiative for a Client with a hard deadline and created an esign process to speed signatures. The project launched then a hurricane hit the state.

Solution: HEOPS quickly identified that a power grid was published hourly on a county by county basis. Using the power grid and a team of network staff HEOPS checked in on all providers, offered assistance and rotated telephonic activity by county and power grid availability.

Success. The project concluded on time, on budget and on target. Providers who needed assistance due to the hurricane were connected with other resources.

Challenge: No Market Recognition and No Lives
A Client sought to develop a statewide PPO and Medicare Advantage Network to rival the benchmark plan. Unfortunately the plan was new and had no market share to drive the contracting initiative.

Solution: With experience in all 50 states, HEOPS utilized local market knowledge to create a value proposition infusing vision, aspiration and administrative simplification to fuel provider interest. Using an omni-channel approach and focused intensity, HEOPS launched a series of “plays” to create interest and then contracted to build the network and close the gaps and at the targeted rate.

Success. The project concluded with network adequacy at a market competitive rate to fuel sales and growth.

Challenge: Provider Readiness and Training
MLTSS providers in Virginia were faced with EVV implementation during the pandemic for Personal Care and Respite Care codes. Initial testing and surveys demonstrated only a 20% Readiness rate.

Solution: As a delegated network, HEOPS worked actively with our Plan partner to accept, test and train providers daily to assist with training, calibration and accuracy. HEOPS also met with EVV vendors and other stakeholders to create a common understanding of the requirements and compliance.

Success. 30 days post implementation The CENTIPEDE Health Network providers were at 99% compliance.

Challenge: Inconsistent State Medicaid Standards and no National Standard for MLTSS, HCBS and SDOH Providers
MLTSS/HCBS/SDOH providers face unique challenges and often lack infrastructure, familiarity with managed care and financial reserves. To deliver in-home services and supports at scale, a national framework for contracting and credentialing was needed and did not yet exist.

Solution: HEOPS created a national MLTSS/HCBS/SDOH network branded The CENTIPEDE Health Network. HEOPS powered this contracting and education initiative to create a national network baseline AND a three (3) tiered credentialing framework for existing and emerging provider categories.

Success. Today The CENTIPEDE Health Network has 50,000 lives under management and is scaling to reduce administrative duplication and speed to market for MLTSS, DSNP, MMP, VBID, PACE, ACO’s and Medicare Advantage (MA Plans). Credentialing turnaround time (TAT) is unparalleled at 1 Day.