The traditional health plan model is optimized for claims processing, not outcomes. Join leadership from Firefly Health and Zus Health for a deep dive into the Clinically-Integrated Health Plan. We explore how merging clinical delivery with longitudinal health data profiles shifts the "locus of control" back to primary care quarterbacks who influence 90% of every medical dollar. 

Firefly and Zus will demonstrate how to move from transactional coding to proactive population health management. By utilizing Risk Adjustment Factor (RAF) scores as a "clinical complexity compass" rather than a billing tool, this model identifies risk early to drive engagement. 
We will discuss how to navigate the friction between product and payer logic to establish clinical guardrails that protect workers. It’s time health plans act as clinical partners to ensure patients are truly protected, not just "covered.”

Session Objectives:

• Understand how longitudinal technology closes the gap between data ingestion and clinical action. 
• Evaluate research linking HDHP designs to adverse health outcomes. 
• Define clinical safety guardrails that protect clinicians and clients by ensuring all “red flag” symptoms and data are followed to resolution or to timely diagnosis and follow-up.