Preserve the context
Make relevant intake information available to the reviewing team.
MEDICARE ADVANTAGE
Keep the member’s next step connected.
Bring member context, network options, and follow-through into an understandable care journey—with clinical review at its center.
MA medical directors · Care management · Plan operations
NeXtriage / IN MOTION01 / 05
Keep care connected.
Continuity is a sequence of clear handoffs
Relevant intake information helps the reviewing team understand the situation.
ILLUSTRATED WORKFLOW
Illustrated continuity concept. It does not represent live care management or a quality-rating result.
Read the complete process
- Carry the context forward. Relevant intake information helps the reviewing team understand the situation.
- Review before recommending. Clinical decision support remains subject to qualified professional judgment.
- Make the next step understandable. Confirm an option that fits the member and the configured plan pathway.
- Connect the handoff. Distinguish a proposed next step from a confirmed transition.
- Keep the team in the picture. Agree who follows up when the planned handoff is not completed.
PRE-HOSPITAL DECISION SUPPORT + IN-FACILITY WORKFLOWSClinical review. Member choice. Clear evidence.
THE ESSENTIAL QUESTION
What should Medicare Advantage teams prioritize in navigation?
Prioritize clinical context, understandable next steps, verified network options, and completed handoffs. Evaluate how the workflow supports members who need help using digital tools, and ensure responsibility is clear when a recommended option cannot be completed.
A WORKFLOW TO EVALUATE
Connect the decision to what happens next.
Make the choice understandable
Explain the next step and confirm the member’s selection.
Verify the handoff
Keep recommendation, member confirmation, and completed care as separate events.
GO DEEPER
Useful before your first demo.
BUYER GUIDE
Evaluate continuity in Medicare Advantage navigation
Questions, implementation considerations, and a pilot readiness checklist for medicare advantage.
↗INTERACTIVE PLANNERExplore handoff completion
Adjust engagement and follow-through assumptions to plan a measurable pilot. Results describe hypothetical activity, not clinical outcomes.
↗Questions worth asking.
Does NeXtriage promise an improvement in Star Ratings?
No. This resource makes no Star Ratings claim. Any quality effect would need a defined measure and supporting evidence.
Are clinical recommendations autonomous?
The product is described as clinical decision support. Qualified professionals must review and validate clinical outputs; implementation should make that responsibility explicit.