01
Revenue & performance
See how risk, quality and financial performance connect. Follow the evidence into the work behind the result.
- Risk Adjustment
- Quality / HEDIS
- Financial planning
- Benchmarking
THE COMMUNITY HEALTH PLAN COLLABORATIVE
Your wholehealth plan.Working as one.
Bring risk, care and financial performance into one view, with the context and next steps your teams need.
Built with community health plans, for the people who run them.
A connected view of the business. A practical place to start.
OneHlth
THE WHOLE PLAN
Connected workOne view. Clear priorities.
Medical costsExperience vs. plan Experience Plan
Quality & riskKnow what needs attention
Gaps to investigate Evidence to review
PRIORITY IN FOCUSWhere is avoidable care increasing?
Bring the trend, its sources and the next step together.
Source contextClaims & member history
Review the evidenceCohort & contributing factors
Coordinate the workOwner, next step & review
CMCare Management + FinanceHuman review
From an important question
to a coordinated response.
01 Understand what matters
02 Connect the right people
03 Keep the work in view
FOLLOW THE WORK
An insight should
lead somewhere.
Explore how an operating question connects to evidence and an accountable next step. In these examples, AI helps prepare the work; people review the decisions.
A question worth answering
Which conditions need a closer look?
Bring the clinical record, claims and prior-year context into the same review.
Shared source context
Start with the evidence
Clinical documentationEncounter and supporting record
Check supportClaims historyDiagnosis and service-date context
Compare sourcesPrior-year conditionsA lead for review, not a new diagnosis
Verify current yearA possible gap is a question to investigate. The supporting record determines what happens next.
ACROSS THE HEALTH PLAN
Start with a priority.
Keep the whole plan in view.
Clinical, financial and operational work are connected. OneHlth brings those perspectives into a common operating model.
02
Cost & care
Understand where costs are changing, which members need attention and what your teams can do next.
- Care Management
- Utilization Management
- Claims
- Payment Integrity
- Fraud, Waste & Abuse
03
Members & providers
Understand provider performance, connect it to contracts and care, and give relationship teams the context to act.
- Member engagement
- Provider Network & VBC
- Credentialing
- Clients
04
The operating backbone
Connect the people, planning and information that keep a health plan moving.
- Team & HR
- Legal & governance
- Data connections
- Data quality
A common foundation: source context, shared work and accountable owners.
How we work with your teamBUILT WITH HEALTH PLANS, FOR HEALTH PLANS
The people closest to the work
should help shape the tools.
OneHlth is being built with community health plans and the health systems behind them. Their operating questions shape the platform, from the executive view to the work on the ground.
Plan-led prioritiesBuild around the problems your team needs to solve.
Long-term participationA collaborative built for the plans and communities it serves.
Shared learning, by choiceWork with participating plans on common questions, with the scope of sharing agreed together.
A PRACTICAL WAY FORWARD
Evaluate a workflow.
Decide with evidence.
A useful evaluation begins with your team’s priorities. Define the starting point together, connect what it needs and judge the result on evidence.
Let’s find your starting point- 01
Choose an operating priority
Start with a specific question, workflow or vendor comparison. Agree on what a useful result would look like.
A defined starting point - 02
Bring the right context together
Work with the relevant people, systems and sources. Make data gaps and integration needs visible from the outset.
A shared view of the work - 03
Evaluate alongside what you use
Compare the workflow with your existing approach. Review the evidence together before deciding how to expand.
An informed next decision
A FEW USEFUL ANSWERS
Before we talk.
Start exploring here.
Bring your specific questions to a walkthrough.
Who is OneHlth for?
Community health plans and the health systems behind them. The platform brings together the perspectives of leadership, finance, clinical teams and the people doing the operational work.
Do we have to replace our existing systems?
Start with a defined operating priority. We work with your team to scope the data, workflow and evaluation criteria, including how to compare alongside an existing process or vendor. The next step depends on the evidence.
Where does AI fit?
Analysis, work preparation and quality review are important areas for AI assistance. The aim is to reduce manual effort while keeping people accountable for decisions. In a walkthrough, we distinguish current capabilities from work that needs additional data or integration.
Can we explore before connecting our data?
Yes. Start with a guided walkthrough. Work with your own data is scoped separately with your team; requesting a walkthrough does not create an account or connect a system.
Does participation require sharing data with other plans?
Your plan’s own operating value comes first. Cross-plan collaboration is a separate choice, with the scope and participation agreed before information is shared.
LET’S LOOK AT YOUR PLAN
What would you like
to work on first?
Tell us where your team wants a clearer view or a better way to work. We’ll use that as the starting point for a conversation.