Why Avēsis?

Avēsis measures program success by how we increase access and utilization, incorporate a community-based approach to solving barriers to healthcare, and build partnerships with local community stakeholders. Our outcomes alleviate the impacts of social determinants of health on the community in need.

A successful government program requires the engagement of the entire health ecosystem; including, family, social, and environmental factors to meet members where they are and deliver positive influence in their lives, health, and overall wellbeing.

Our programs and partnerships aspire to:

  • Lift up the communities we serve
  • Serve the underserved
  • Relentlessly pursue innovation
  • Responsibly break down barriers to health
  • Focus on the care, not the claim
  • Amplify solutions to reduce the impacts of Social Determinants of Health

Here to help you succeed

Going beyond dental and vision, Avēsis delivers an integrated model of care, treating the whole person. We build communities of care, breaking down social determinants around food insecurity and nutrition, transportation, employment, and more that impact health. Coordinating with our government and MCO partners on the numerous complexities of a person’s care, we produce better health outcomes for members — and more consistent, efficient spending for you.

Integration of care platforms

We integrate with partners to deliver holistic managed care programs to serve the most underserved in rural communities, members with intellectual and developmental disabilities, and where safety nets no longer reach.

Collaborative community relationships

We build community health networks with local stakeholders, providers, and health resources to advance population health. We commit to the whole-person, proactively helping communities connect members to resources beyond traditional medical, dental, and vision services.

Building health equity

Our mission challenges us to reduce health disparities in the communities we serve. We strive to deliver equal access to quality health care — regardless of age, sex, race, gender identity, sexual orientation, religion, education level, ability, or wealth.

 

FAQs

How do our programs focus on health equity?

We believe that health equity has a ZIP code. Solutions must be built and applied using local determinants of health. As a member-first organization we have built an integrated platform to deliver whole body health, including dental and vision in additional to programming specifically designed to reduce or eliminate barriers to health. These include platforms focused on nutrition and food insecurity, transportation, individuals with developmental disabilities (IDD), and workforce related issues.

How do we identify under-served areas and populations?

Our first objective is building trust in the community through a centered approach on individual needs. An essential task is making the care experience accessible, easy, more effective, and culturally sensitive. Better health outcomes, lower costs through prevention, and happier members must be the focus to everyone we serve. We are deploying programs targeting IDD, rural, immigrant and refugee populations, and the chronically underserved to ensure access is met at the same level as all other members.

How do we determine network adequacy and build effective networks?

Network adequacy means more than just having a provider in the network. We must ensure those practices thrive on our programs to ensure they continue to value our members. A one size fits all model with a network leaves significant gaps in care as members move away from population centers; building a network based on the evolving needs of our members is essential to overall success.

Are you offering alternative payment models to support network growth strategies?

Our structure to reduce cost, institute value-based care and volume-based strategies are centered on what provides the greatest member and provider experience. We do not rely on cost reduction strategies, such as systems and clinical edits that restrict the services a member can access, but rather focus on long-term cost avoidance strategies by improving access to care delivery models designed to make the member healthier. These models include telehealth, minimally invasive care, and integrated personalized care.

Change Healthcare
Status Update

The Change Healthcare security incident is being investigated and they are working to restore services in the most safe and efficient manner. Currently, we do not have any details regarding potential impacts to members, providers, or other stakeholders, nor an estimated time for resolution. We have established temporary work arounds for the most critical services affecting member care and provider’s needs, where possible. We will provide updates as we have them, and appreciate your patience while our vendor, Change Healthcare works to resolve the issue.