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Reimagining Care for Vulnerable Populations: A Retrospective on the PCIC and Amerigroup Partnership Featured

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“We want to make an impact, but we don’t know if we’re helping the people who need it most, and we have a hard time tracking the long-term impact of our outreach team’s interventions.” Sound familiar?

PCIC can help—for example, our data-driven interventions in partnership with Amerigroup in 2023 led to a 75% reduction in hospital visits, a 72% decrease in healthcare costs, and a reported 12% improvement in quality of life for the enrolled patients.

These outcomes highlight PCIC’s ability to act as not just a partner, but an extension of our partners' teams, enabling you to maximize your resources with proven strategies that make a tangible impact.

Data-Driven Interventions with a Person-Centered Approach

In 2023, Patient Care Intervention Center (PCIC) and Amerigroup partnered to improve healthcare for vulnerable populations. By using PCIC's data tools, our teams identified individuals with serious health challenges, including those affected by social issues like financial instability and lack of housing. This partnership focused on understanding each person's unique needs and provided personalized care, making a positive difference in their lives.


Thomas, a PCIC client, speaks to how the collaboration between PCIC and Amerigroup was life-changing for him.

How PCIC Connected the Dots

PCIC’s unique expertise in both advanced data analytics and comprehensive intervention services has been pivotal in identifying and addressing the needs of individuals facing significant vulnerabilities within Amerigroup’s network.

Using PCIC’s robust data analytics software and intervention services, Amerigroup could focus on clients with signs of acute need, such as frequent emergency room visits and a complex mix of clinical and behavioral health challenges.

These indicators often highlight underlying issues that traditional care models might overlook, including the Social Determinants of Health (SDoH) such as economic instability, housing insecurity, and access to nutritious food.
graphic summarizing social determinants of health for vulnerable populations
PCIC’s intervention team, led by Tara Pitts, MSW, worked closely with clients to understand their personal priorities and the barriers they faced to wellness. This person-centered approach ensured that care was tailored to each client's immediate and long-term needs, taking into account the broader context of their lives and the social factors affecting their health.

The Power of Partnership

The success of this initiative demonstrates the potential for other healthcare and social service organizations to partner with specialized agencies like PCIC. These collaborations can uncover new ways to address complex patient needs, improve care delivery, and tackle the root causes of health disparities, ultimately enhancing health outcomes.

We invite other organizations to partner with PCIC, as these partnerships can lead to meaningful changes toward a healthier, more equitable society. Beyond just data sharing and analysis, PCIC can assist your team in brainstorming effective strategies for implementing and monitoring interventions related to SDoH. We also offer customized dashboards and reporting tools to help track and evaluate the progress of your initiatives.

If your team would like to partner with PCIC for data-driven interventions, contact Tara Pitts at This email address is being protected from spambots. You need JavaScript enabled to view it..
Last modified on Monday, 28 October 2024 15:56

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Humanize health equity by integrating clinical, behavioral, and social determinants of health into serviceable insights that our partners use to drive action, putting each individual on a path toward achievable health and well-being.

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Creating a new reality of integrated effective care that will transform the lives of all people, especially vulnerable populations – a beacon for True Health Equity.

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