Our Health Plan Partners

We believe the best care setting is the home. It’s where people are most comfortable and, if given the choice, most seniors want medical access at home and on-demand. With that in mind, we created an innovative, whole-person Home-Based Care Delivery model just for them across their entire healthcare journey taking control of the total episode of care. We are managing the entire patient whether we are providing it at home, or via telehealth, or in our mobile care centers on wheels.

Our mission is to align home-based healthcare-service delivery with patient-centered care across the continuum of care supported by value-based reimbursement to improve health outcomes and lower total cost of care through our high-touch Advanced Primary Care model.

Our Healthy at Home model and
Advanced Primary Care Goals:

Move to Value

Increase Healthcare Equity

Improve Quality

Transform the Member Experience

Improve Outcomes

Right Care.

Advanced Primary Care, Acute Care & Post-Acute Care

Right Place.

At home, virtually and in
community mobile clinics

Right Time.

Medical Assistance
available 24/7/365

Bringing care to patients where and when they need it is not enough. We also consider each patient's life experiences, socioeconomic status, family structure, and access to resources like food, housing, and healthcare.

The Sage Health integrated geriatric care delivery model is led by an interdisciplinary care team to deliver value-based Advanced Primary Care focused exclusively on senior adults comprised of:

Provider assisting older woman
  • A geriatric care model.
  • Specifically trained staff with expertise in the whole-person care of older adults for longitudinal, acute, and/or post-acute care at home.
  • High-performing interdisciplinary care teams with the ability to demonstrate measurable results.
  • Strategies aimed at coordinating, communicating with, and supporting caregivers.
  • Protocols for determining patient goals and preferences to prioritize concordant care.
  • A care model addressing common geriatric syndromes like falls, delirium, and incontinence.
  • Preventing polypharmacy (too many medications, inappropriate medication, or the wrong dosage of medication) for older adults..

Person-Centered Care

We put patients at the center and make everything we do about both bettering the patient experience and improving health outcomes. This model of patient-centered care is driven by our senior’s specific health needs and their desired health outcomes and is the guiding force behind all healthcare decisions and quality measurements at Sage Health.

Personalized & Comprehensive

The Sage Health interdisciplinary care team considers a variety of patient factors — age, care preferences, ability to function independently, fall hazards in their home, and social and behavioral needs — when working with them to make their personalized, comprehensive care plans.

Technology Enabled

Our high-touch care model increases access to care by meeting seniors wherever they are, whenever they need it most and leveraging virtual care and remote patient monitoring technologies so that seniors can see a nurse or doctor, or even “visit” the emergency room, all without leaving the couch.

Over 35 million Medicare beneficiaries are living with two or more chronic diseases. It’s imperative to help improve outcomes for this financially and medically vulnerable population.

We believe that if you improve the health of the patient, then the cost follows. Improved health always leads to reduce costs especially for the medically complex, chronic senior population. The Sage Health high-quality complex care interventions are comprised of:

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Patient-Centered

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Interdisciplinary Teams

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Whole-Person Care

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Population Health Management

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Evidence-Based Care Programs

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Care Coordination

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Telehealth

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Improved Quality of Care

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