Organization
Transcarent
Case study
Care navigation that cut avoidable escalations
Reframed success metrics around completed care plans to reduce rework and clinician load.
Timeframe
2020–2022
Focus
Redacted, de-identified outcomes
Overview
Case study overview
A redacted summary of the system, constraints, and outcomes.
Summary
Reframed success metrics around completed care plans to reduce rework and clinician load.
Escalations surged because guidance was fragmented across teams and member records lacked a single source of truth.
Problem
Reframed success metrics around completed care plans to reduce rework and clinician load.
Intervention
Unified member record for clinicians and care guides.
Impact
Escalations reduced as ownership and routing became clearer.
Case study detail
Constraints
- Clinical governance and benefit partner rules.
- Variable patient acuity and time-sensitive routing.
- Operators needed a unified narrative for handoffs.
Interventions
- Unified member record for clinicians and care guides.
- Routing rules tied to clinician ownership.
- Completion dashboards and handoff rituals.
Outcomes
- Escalations reduced as ownership and routing became clearer.
- Care plan completion became more consistent across teams.
- Operators reported clearer ownership on tricky cases.
Artifacts
- Routing rule map with owner assignments.
- Care plan completion dashboard (redacted).
- Handoff ritual checklist.