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At Centene, we believe in finding new and effective solutions that respond to the complex health needs of our members. By combining active local involvement in our communities with a commitment to whole health, Centene has established programs that work to remove many of the barriers facing healthcare consumers. Oftentimes, these successful health management programs are a result of collaborations with community partners and other stakeholders.

How We Do It

Centene’s Clinical Programs team collaborates with our Enterprise Analytics group to develop a comprehensive portfolio of programs to advance health outcomes for Centene’s members. Through deployment of the Identify, Stratify, Manage, Measure, and Disseminate (ISMMD) model, each clinical program is developed by leveraging cutting-edge clinical guidelines, evidence-based best practices, and data science. Implementation of each of the clinical programs is measured through continuous monitoring, benchmarking, and a rigorous goal-setting process. Three examples of Centene’s clinical programs are listed below. They continue to set the industry standard in quality and clinical program development by emphasizing the highest level of methodology and analysis.

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ISMMD model

Fluvention?

Centene’s multipronged Fluvention? campaign was designed to promote vaccinations as the key to flu prevention. By increasing annual influenza vaccination rates in high-risk members, health-related complications and excess healthcare costs are greatly reduced. The Fluvention? program empowers health plans to improve overall flu vaccination rates by distributing education materials to members and providers enterprise-wide, as well as increasing access to facilities that provide flu vaccinations. The program has a proven track record of increasing flu vaccination rates among Centene’s membership year-over-year.

Start Smart for Your Baby?

With a focus on pregnant members, new moms, and their babies, Centene’s award-winning education and outreach program, Start Smart for Your Baby? (SSFB) promotes member engagement designed to achieve healthy pregnancies while preventing premature births and admissions to neonatal intensive care units. The SSFB program incorporates the concepts of care management, care coordination, disease management, and health education in an effort to improve maternal and infant health. A wide range of care management techniques aim to improve obstetric and pediatric care services while reducing pregnancy-related complications, premature deliveries, low birth weight deliveries, and infant disease. Reductions in the number of low birth weight deliveries have resulted in substantial improvements in health outcomes. Outreach activities such as baby showers connect members with clinical teams, care coordinators, and community partners in a fun and engaging setting. Several Start Smart initiatives have received leading healthcare industry awards, including Case-In-Point Platinum Awards.

Readmission Reduction

The Readmission Reduction program aims to reduce preventable readmissions by working to ensure optimal transitional care from acute and non-acute settings. The program focuses on placing post-hospitalization outreach calls to members to ensure they understand their discharge instructions, plan to follow up with a primary care provider, and discuss medication reconciliation. Additionally, the highest-risk members are linked with a community health worker home-visiting program. Through the implementation of the program, Centene aims to avert 15% of preventable readmissions.

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