For health plans and payers
Coordinate member care and protect financial performance
Rovicare helps health plans manage high-acuity episodes, referrals, renewal support, and authorization workflows. Connect your teams with providers and community partners around the next action a member needs.
Capabilities
- High-acuity episode management
- Redetermination coordination
- Prior authorization
- Network referrals
- Quality dashboards
Outcomes we help you pursue
- Lower total cost of care
- Fewer readmissions
- Higher quality performance
- Preserved membership revenue
- Regulatory readiness
Plan priorities
Lower total cost of care, stronger quality performance, and membership continuity require operational follow-through. Give teams visibility into unresolved needs and clear ownership of action.
Redetermination and retention
Organize renewal outreach across health plan, provider, and community teams. Track missing information and verified outcomes to help eligible members maintain coverage.
Outcome source: state eligibility file, received 10/28. Submission, active coverage and same-plan retention are reported separately.
High-acuity episodes
Coordinate transitions and post-event follow-up through Command Center. Prioritize outreach, track provider responses, and follow services through the agreed episode window.
- Admission or crisis event
- Work assigned
- Provider referral
- Member outreach
- Follow-up completed
Quality and financial dashboards
Review program activity, overdue actions, service initiation, and verified outcomes. Connect operational reporting with quality and financial measures using the data and definitions appropriate to each program. Projected financial value is always shown separately from measured outcomes.
Operational activity is distinct from formal quality measure results.
Renewal business case
Model the value of helping eligible members stay covered using your own cohort, capitation and contribution assumptions.
Renewal business case (health plan view)
Licensing + implementation + integrations + usage + operating effort
Enter your assumptions to see the model
All required fields, including a nonzero cost, are needed. No preset savings are assumed.
Projected value using your assumptions. Gross capitation and its derived contribution are never added together. Verified results come from actual renewal decisions.
Customer evidence
Explore examples from health plan implementations. Assess the specific use case, participating organizations, and measurable results.
Implementation
Start with a defined population and workflow. Agree on data sources, participant roles, access, integration scope, success measures, and a practical rollout plan.
Frequently asked questions
More answers on our FAQs page.
Tell us which program has the greatest urgency
We will tailor a demonstration around its care, quality, and financial goals.