Boost Health Plan Performance and Member Engagement

86Borders delivers meaningful results to health plans, improves CMS Star Ratings and quality metrics, and addresses the Health Equity Index through building trusted relationships with members.

Whether your main goal is to improve CMS Star Ratings, close HEDIS®, CAHPS® and HOS gaps in care, address the Health Equity Index, or improve member experience, 86Borders provides unique, tailored engagement solutions that advance your health plan performance.

Some of our solutions include:

Member Activation

Medication Adherence

Appropriate Benefit Utilization

Colorectal Cancer Screening

Breast Cancer Screening

Health Equity / Social Determinants of Health


Annual Wellness Visit

Post Discharge Follow-up

CMS Star Ratings and HEDIS®/CAHPS®/HOS Gap Closures

86Borders uses actionable data to address a health plan’s most pressing CMS Star Ratings and quality metrics.

We develop trusted local relationships with members, providers, pharmacies, community-based organizations, and transportation vendors. We also schedule appointments, create reminders, and use CAHPS®/HOS language with members.

Advantages to Health Plans:

Activate previously unreachable or inactive members

Increase member satisfaction

Drive improved health outcomes

Address Health Equity and SDOH

Health Equity Index/ Social Determinants of Health (SDOH)

As a leader in the SDOH space, we identify and address health equity and social needs at a member level and summarize at an aggregate level for reporting.

We remove barriers to access and ensure members have the resources they need.

Advantages to Health Plans:

Enhance member-level demographic and SDOH data, particularly as it relates to the CMS Health Equity Index (collect and report Z Codes and LOINC Codes)

Improve member experience

Strengthen the health plan’s reputation

Member Benefits and Appropriate Utilization

Coordinate benefits and remove barriers.

Our ability to reach out and uniquely engage members in their preferred method of communication allows us to better educate them on their member benefits. We coordinate benefits, including medical, behavioral, dental, vision, wellness, and supplemental/OTC.

Advantages to Health Plans:

Promote brand loyalty, member retention, and growth

Improve appropriate utilization for preventative or annual care, and supplemental benefits

Provide meaningful contribution to the Medical Loss Ratio threshold

Contact us to develop a tailored, multifaceted solution for your health plan and learn about our successes with existing programs.