Overview
LEON Health is a 5-star rated Medicare Advantage Plan serving nearly 40,000 Medicare recipients at eight LEON Health Centers in Miami-Dade County, Florida. Leon Health earned a 5-star rating from CMS in their first year of eligibility and continues to maintain that rating today. This is the highest rating that CMS can award to a plan. The health centers operate as “one-stop shop” facilities, offering a comprehensive range of services (primary care, specialty care, lab services and more). They offer five plans for potential members to choose from.
In April of 2021, LEON Health executed agreements with RAM Health for an enterprise software platform, HEALTHsuite Advantage™ (core solution) and eHealthsuite™ (integrated member and provider portals). LEON Health had just five months to prepare for Open Enrollment, and six months to prepare for full-scale production operations. LEON Health needed a partner with an impeccable track record and an expedited, yet thorough implementation process. That led them to RAM Health, who specialize in providing healthcare administration solutions for Medicare Advantage plans utilizing a proven rapid implementation methodology.
Solution
RAM Health deployed and implemented their HEALTHsuite Advantage and eHealthsuite platform, providing LEON Health with an intuitive enterprise solution to administer their new Medicare Advantage business. Some of the benefits LEON Health has experienced with the RAM Health solution include:
- HEALTHsuite Advantage is a fully integrated solution from enrollment to encounter reporting – eliminating the need for third-party bolt-on solutions or complex integrations
- RAM developed and maintains their solution in-house, ensuring that LEON Health has direct access to industry and solution experts when needed
- HEALTHsuite Advantage manages all bidirectional exchange of data with CMS, including continuous updates to ensure that LEON Health remains compliant with new and evolving regulatory requirements
- eHealthsuite member and provider portals share the same database instance with HEALTHsuite Advantage, offering 24 x 7 access to members and providers resulting in fewer calls to customer service
Additionally, HEALTHsuite Advantage deploys in a pre-configured state. It is designed to eliminate implementation risk and reduce the overall workload for health plan staff, enabling a fast, accurate implementation. “We were very impressed with RAM Health’s methodology and accelerated implementation for our health plan. Expectations were well set, and workload was significantly less than we anticipated,” says Henry Hernandez, LEON Health’s president and CEO.
Results
“Results The results of implementing HEALTHsuite Advantage have been exceptional. “As of January 2022, we had enrolled over 22,000 members in our initial open enrollment period and the process went very smoothly,” said Hernandez. “We have continued to increase our membership and now have over 38,000 members being administered on the HEALTHsuite Advantage application.”
“There are very few software companies that could have implemented a system that quickly with the level of quality and accuracy that RAM delivered.”- Ernie Otero, LEON Health IT Director
“As of January 2022, we had enrolled over 22,000 members in our initial open enrollment period and the process went very smoothly.”Henry Hernandez, LEON Health President and CEO
“There are very few software companies that could have implemented a system that quickly with the level of quality and accuracy that RAM delivered,” says Ernie Otero, LEON Health’s IT director. HEALTHsuite Advantage’s BI & Analytics reporting platform has been particularly beneficial, providing real time data. “We do a lot of reporting and data analysis in our shop. The HEALTHsuite Advantage analytics solution allows us to do that essentially in real time, so we know how the system and the health plan are performing at all times.” Giancarlo Tiffer, LEON Health’s vice president of operations, praised HEALTHsuite Advantage’s enrollment module and how it increased productivity. “I really like the ease of use of HEALTHsuite Advantage’s enrollment module,” says Tiffer, “the automation and built in workflow features really simplify the MA enrollment process. Enrolling over 38,000 members in two years with next to no errors is an amazing statistic.”
Tiffer also highlighted the importance of RAM’s training and 24/7 troubleshooting support, which were key to the successful implementation. “From day one, RAM Health’s support has been outstanding,” adds Tiffer. “The on-site training was excellent, and RAM is always available to quickly answer questions and assist us with any issues.”
Moreover, Tiffer was impressed with RAM Health’s commitment to continuous improvement. “Their staff is constantly looking for ways to add functionality and improve their products,” he says. “Plus, they really welcome our feedback, which is very rare in this industry. That’s something that truly stands out about them.”
According to Hernandez, the eHealthsuite portal has also proven to be a significant asset, particularly in managing their provider population and helping improve staff efficiency. “Since deploying the eHealthsuite web portals calls to our provider services line have decreased substantially allowing our staff to be productive in other areas,” said Hernandez.
