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    03 — Value stream · VS-520

    Enroll-to-Care

    Enroll a member in the right plan, understand their health risks and needs, reach out and engage them, and connect them with care management, in-network clinicians and community resources so their care is coordinated. Delivering the care itself is the provider's.

    • Member Lifecycle
    • Enrollment-to-Engagement
    • Member Journey
    • Onboard-to-Care
    // FIG. 03 · Stage flow
    1Enroll2Engage3Assess Risk & Nee…4Connect to Care5Manage Care6Measure Outcomes
    1. 01

      Enroll

      VS-520.10

      Enroll the member, confirm eligibility, issue coverage under the right plan and send the ID card and welcome.

    2. 02

      Engage

      VS-520.30

      Reach the member with reminders and outreach through the channels they use, and invite them to complete a health risk assessment.

    3. 03

      Assess Risk & Needs

      VS-520.20

      Stratify the member's health risk from claims, clinical data and a health risk assessment, and screen for social needs.

    4. 04

      Connect to Care

      VS-520.40

      Match the member to in-network primary care and specialists and close gaps in care.

    5. 05

      Manage Care

      VS-520.50

      Enroll higher-risk members in care management and coordinate with their clinicians and community services.

    6. 06

      Measure Outcomes

      VS-520.60

      Measure quality, cost and experience for the population and under value-based contracts.