Concept preview prepared for 86Borders. Not affiliated.

86Borders Talk to us
MenuClose

LanguageENES

Talk to us
General inquiries
inquiries@86borders.com

LanguageENES

Human‑first care for hard‑to‑reach members

Talk to us

For health plans and their members, by local Care Coordinators

Representative image: a man and his mother laugh together in her vegetable garden
Representative image: an older couple laughing together on the bench of their front porch
Representative image: a woman smiles on the phone on her front steps with a cup of coffee
Representative image: a grandfather, his daughter and two children laugh over breakfastRepresentative image: a man carries two bags of groceries up the steps of his houseRepresentative image: a granddaughter helps her grandfather go through his mail at the tableRepresentative image: a driver helps an older woman with a cane into a car outside her home
Representative image: a nurse talks with a smiling girl and her mother at a checkup
Representative image: a care coordinator in a headset laughs during a call
Representative image: a woman does a gentle stretch on a mat in her sunny living room

same coordinator, every call

ride booked for Tuesday

Representative images, not real members or staff

Where the borders are

Care gaps open in ordinary places: a bus stop, a pharmacy counter, a front porch, a market aisle. Our local Care Coordinators meet Medicare Advantage, Medicaid, D‑SNP, Exchange and Veteran members in those places, and stay with them until the need is met.

Representative images, not real members or staff

  1. Representative image: an older man with a gray beard walking to a neighborhood bus stop

    visit booked once the ride was set

    The bus stop

    The ride comes first

    No ride usually means no appointment. So the first call is often about getting there, and the visit gets booked once the ride is set.

  2. Representative image: a pharmacist hands an older woman her prescription bag across the counter

    statin refill picked up

    The pharmacy

    Prescriptions picked up, and taken

    Medication adherence moves Star Ratings one refill at a time. Coordinators work from pharmacy data, call when a statin or blood-pressure refill goes quiet, and sort out what is in the way: the cost, the ride, the side effect nobody mentioned.

  3. Representative image: a grandmother reads a picture book with her young grandson on the sofa

    checkup, mammogram, eye exam: all booked

    The front porch

    One conversation for the whole household

    Members live in families, so we reach them that way. ConnectAllCare links the people in a household, and a single outreach can settle a child’s checkup, a mother’s mammogram and a grandfather’s eye exam. Spanish-speaking coordinators call the households that prefer Spanish.

  4. Representative image: a father with his baby in a carrier unpacks groceries and diapers

    food help connected first

    The market

    Food, diapers, housing, a ride

    A member worried about groceries or rent will not put a colorectal screening first, and nobody should expect them to. We connect the social needs that sit in front of the medical one, and document them for the plan along the way.

  5. Representative image: an older woman leaves a clinic with her son, holding a folder and smiling

    screening done, result confirmed

    The need met

    Screened, closed, confirmed

    We stay until the screening is completed, the result is confirmed and the next step is booked. That is the only kind of engagement we count.

How the work gets done

What every outreach rests on

Representative image: a care coordinator with a headset smiles while taking notes on a call
Representative image: two care coordinators laugh together over a laptop in a bright office

household linked, open gaps in view

Representative images, not real members or staff

  • The human touch

    Locally based Care Coordinators, not a call center. People who know the neighborhoods they call, including Spanish-speaking coordinators, and who earn a member’s trust before asking for anything.

  • Technology that amplifies

    ConnectAllCare puts the household, the verified phone number and the open gaps in front of the coordinator, so the time goes into the conversation instead of the search.

  • Outcomes that are real

    We count completed actions: the screening done, the prescription filled, the result confirmed. A dialed number or a voicemail is not engagement.

One coordinator, four steps

The same person carries a member from the first hello to the confirmed result.

  1. Step 1: Engage and activate

    Find the member on a number that works and earn the first yes, often through a family member they trust.

  2. Step 2: Address social needs

    Rides, food, diapers, housing: the needs that block care get handled first.

  3. Step 3: Close gaps in care

    Screenings, refills and provider visits, booked, reminded and kept.

  4. Step 4: Track results

    Every interaction logged in ConnectAllCare, followed up until the result is confirmed.

The model in depth

Five memberships, five sets of borders

Each plan type brings its own members, its own measures and its own reasons a call goes unanswered.

Representative image: an older man in a cap smiles on a park bench with his coffee
Representative image: a young mother takes a call on the sofa while her toddler stacks blocks

number verified, member reached

Representative images, not real members or staff

How we work with each plan type

Results, one plan at a time

Six published results from 86Borders programs.

  • 99% HEDIS® SNS-E intervention rate An Exchange plan
  • 10% Reduction in total cost of care A Medicaid plan
  • 19% Reduction in inpatient and ER utilization A Medicaid plan
  • +22 Weighted Star improvement A D‑SNP plan
  • 12:1 ROI for risk adjustment (RAF) A Medicare Advantage plan
  • 96% Improvement in the HEDIS® CBP measure An Exchange plan

Each figure is one plan’s published result, shown with its plan type. None is an average across plans, and none is a guarantee.

A representative member journey

Two screenings, one morning

  1. Representative image: a woman smiles on a phone call at her kitchen table, a pill box in front of her

    Challenge

    A Spanish-speaking member living with diabetes had missed her eye exam two years running. Automated reminders in English went unanswered, and the clinic was two bus transfers away.

  2. Representative image: a smiling care coordinator in glasses wearing a headset

    Action

    A Spanish-speaking Care Coordinator reached her through her son, booked the retinal exam and an overdue mammogram for the same morning, and arranged the ride.

  3. Representative image: an older woman laughs with a technician after her eye exam

    Impact

    Both screenings were completed. The coordinator confirmed the results reached her primary care doctor and set the follow-up visit.

both screenings done the same morning

A composite drawn from common situations. Not a real member, and no real details.

Representative images, not real members or staff

Named one of Modern Healthcare’s Best Places to Work in Healthcare for 2026.

The work depends on the people who make the calls, so how we treat them matters.

Bring us the members you have not been able to reach

Tell us which measures you are chasing, which populations are hardest to reach and what you need to show by the next reporting cycle. We will tell you plainly where human outreach can move them.

Talk to us
Representative image: a grandfather and his granddaughter walk hand in hand down a sidewalk
Representative image: two older neighbors laugh over a garden fence with cups of tea

next step booked

Representative images, not real members or staff