Wakely Integrated Dual Enrollment Navigator (WIDEN)
For dual-eligible integration strategy support, align with WIDEN.
Dual eligible members are the highest cost population in the U.S., and the lack of alignment of Medicaid and Medicare coverage for these members presents both challenges and opportunities for health plans seeking to deliver value. Policy changes are taking place at the state and federal levels to address the challenges — but only the health plans prepared for these changes will be able to seize the opportunities in managed care for Medicaid and Medicare.
The Wakely Integrated Dual Enrollment Navigator (WIDEN) gives your organization in-depth insights for dual eligible strategy support. With WIDEN, you can better capitalize on policy changes and alignment opportunities, putting your plan — and your members — on the winning side of the equation.
Request a consultation to learn more about WIDEN.
Widen your view of the market – and your growth opportunities.
The deep insights provided by the WIDEN tool are presented in an interactive Power BI dashboard, which offers two sets of views: pre-built views available immediately, and views customized to your portfolio. The customized client views are developed collaboratively with your organization to provide a competitor-level analysis of enrollment patterns. This analysis can be segmented by plan, county or region, and Medicaid population with imputed cost, revenue and MLR information. Customized views are combined with our network dashboard to identity providers serving the populations you prioritize for outreach.
Pre-built views include:
- National View – A comparison of state-wide managed Medicaid percentages and managed Medicare percentages across all managed care organizations (MCOs).
- MCO National Views – For any selected MCO, WIDEN shows what their managed care market share looks like, how their members are aligned, and the opportunity for alignment among managed care and fee-for-service beneficiaries.
- Market Share/Opportunity Summary – A summary of alignment opportunities that features key information from other views in an easy-to-export Excel format.
- CMS Special Needs Plan (SNP) Data – Shows recent enrollment patterns with Medicare SNPs.
- State Market Overview – Gives you a better understanding of the competitive landscape within a particular state.
Customized client views include:
- MCO State View – Provides a market overview that identifies competitors with high enrollment of the selected MCO’s enrollees on the other side (Medicaid or Medicare). This view may be segmented by Medicaid product and current coverage source (including plan, ACO, or FFS) and includes imputed MLR for cohort comparison.
- Priority List Selector –Allows clients to narrow down to a population of focus. Filter by Medicaid MCO, MA Plan or ACO, county or region, and type of long term services and supports (e.g. nursing facility, home and community-based care or none).
- Priority Lists – After a set of populations of focus are selected, the filters for these lists feed the next stage: the customized client network dashboard. The dashboard shows members, utilization and imputed spending for each Medicare provider. The priority lists also appear as tabs on this dashboard for later reference.
- Geographic Analysis: All customized client views support analysis geographically, allowing users to analyze data at the state level or focus on specific regions and counties.
What your organization can do with WIDEN.
With the insights gained from WIDEN, your organization is ready to:
- More fully understand the dual enrollment market
- Navigate and adapt to upcoming policy changes
- Assess the latest dual enrollment patterns across multiple states
- Identify misaligned members (those enrolled with the MCO for Medicaid but with a different carrier, ACO, or FFS Medicare)
- Prioritize target populations to transition into your integrated managed care plan
Our consultants take WIDEN data from insight to action.
Wakely’s actuarial experts guide you through the dashboards and data, helping you tailor your dual eligible integration strategy to suit your organization’s strengths, opportunities, and risks. Wakely built this proprietary tool using our data use agreement with the CMS Virtual Research Data Center (VRDC), as well as our own managed care, actuarial and data science expertise. Let us put it to work for your organization.
