Delivering Whole Person Care means coordinating medical, behavioral, functional, and social needs across time — not just addressing isolated visits or conditions. It shifts organizations from a reactive, encounter-based model to a proactive, longitudinal approach that anticipates risk, stabilizes patients, and strengthens outcomes across the continuum of care.
Introduction to Driver
Deliver Whole Person Care
Tactics & Workflows
User Personas
Delivering Whole Person Care enables high-value, coordinated care by supporting teams in proactively managing medical, behavioral, and social needs—reducing avoidable utilization, stabilizing high-risk patients, and improving outcomes.
Why It Matters
Fragmented care drives avoidable admissions, readmissions, emergency department use, and unmanaged total cost of care, directly impacting performance in Medicare Advantage, MSSP, and other risk-bearing contracts.
Product Package
Enablement
Without coordinated longitudinal support, patients struggle with adherence, follow-up, behavioral health needs, and social barriers, undermining chronic disease control and destabilizing outcomes.
Resources
Click to View the Full Industry Context Handbook
Key Insight
Organizations that operationalize structured care management — including transitions oversight, chronic disease management, medication optimization, and social needs integration — consistently reduce avoidable utilization while improving quality performance and financial sustainability.
How Do We Operationalize This Driver?
Introduction to Driver
Deliver Whole Person Care
These tactics make care coordination structured and actionable across teams. Organizations can proactively identify, engage, and stabilize patients where fragmentation and avoidable risk are greatest.
Tactics & Workflows
Click into each of the tactics below to learn more and view its workflows.
User Personas
Improving quality performance enables the delivery of high-value, evidence-based care by supporting PCPs and specialists in closing care gaps, reducing complications, and improving outcomes.
Implement a Complex Care Management strategy
Deploy a unified care team to manage transitions of care
Support patients with medication management
Product Package
Enablement
Deploy proactive Disease Management
Support aging in place / EOL
Address Social Determinants of Health (SDOH)
Resources
Integrate and Coordinate Behavioral Health
Click to View the Full Tactic & workflows handbook
Who Should We Engage and How?
Introduction to Driver
Delivering Whole Person Care requires coordinated engagement across clinical, operational, and community-facing roles. Success depends on aligning care managers, primary care, specialists, pharmacists, and social support teams around shared accountability for longitudinal patient outcomes.
Deliver Whole Person Care
Tactics & Workflows
User Personas
Improving quality performance enables the delivery of high-value, evidence-based care by supporting PCPs and specialists in closing care gaps, reducing complications, and improving outcomes.
Providers
- Strategically deploy care management programs
- Transitions of care
- Disease/Complex care management
- Medication Management
- End of Life
- SDOH
- Behavioral Health
Provider Persona Example
Product Package
Enablement
Resources
Payers
More Persona Resources
- Enable providers to administer a connected, trusted care team
Introduction to Driver
Deliver Whole Person Care
What Solutions Support This Driver?
Tactics & Workflows
Delivering Whole Person Care requires integrated data, coordinated workflows, and purpose-built care management capabilities that enable proactive, longitudinal patient engagement across settings.
User Personas
Improving quality performance enables the delivery of high-value, evidence-based care by supporting PCPs and specialists in closing care gaps, reducing complications, and improving outcomes.
Product Package
Analytics, IT & IS
Care Navigation
Arcadia Essentials
Enablement
Scale, security & automation for enterprise data management
Scale personalized care delivery
Foundational capabilities for ACOs and health systems
Resources
Value Add
Core
Value Add
Product Package Resources
Introduction to Driver
How Do We Connect Value to Action?
Deliver Whole Person Care
This guidance helps customer-facing teams connect the Deliver Whole Person Care driver to customer priorities, align cross-functional stakeholders, and advance adoption using Arcadia’s care management, analytics, and coordination workflows.
Tactics & Workflows
Guiding Customer Conversations
User Personas
Improving quality performance enables the delivery of high-value, evidence-based care by supporting PCPs and specialists in closing care gaps, reducing complications, and improving outcomes.
The tools below support productive conversations, establish shared expectations, and move discussions toward clear next steps. Click the tiles below to learn more.
Product Package
Discovery Questions
Engaging Key Stakeholders
What "Good" Looks Like
Moving From Discussion to Action
Enablement
Resources
Implementation & Configuration Guidance
This resource supports implementation and configuration decisions for customers advancing Whole Person Care. The handbook highlights key considerations, workflow design choices, and early scoping questions to help teams align automation, documentation, and reporting to real care management use cases.
Click to View the Implementation & Configuration handbook
What Resources Support This Work?
Introduction to Driver
Deliver Whole Person Care
Explore guides, tools, and learning resources that support the Deliver Whole Person Care Driver.
Tactics & Workflows
Drivers of Success Source of Truth
User Personas
Improving quality performance enables the delivery of high-value, evidence-based care by supporting PCPs and specialists in closing care gaps, reducing complications, and improving outcomes.
Deliver Whole Person Care Driver Handbooks
- Driver Handbook: Part I Industry Context
Product Package
- Driver Handbook: Part II Tactics & Workflows
- Driver Handbook: Part III Implementation & Configuration
Enablement
Product Package Resources
Resources
LMS Resources
- Deliver Whole Person Care Training - Coming Soon
Workflows
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
Tactic: Deploy a unified care team to manage transitions of care
Stratify your population and identify impactable patients.
Establishing early alerts and notifications of necessary transitions of care allows the care team maximum impact.
Enroll and outreach to your population.
What Success Looks Like
Success is achieved when transitions of care are proactively identified and managed through a coordinated, accountable care team, ensuring no patient is lost during high-risk handoffs. This results in measurable reductions in avoidable utilization, improved patient experience, and stronger performance under value-based contracts.
Coordinate Care Management operations and workloads.
Document your Assessment and Care Plan (goals + interventions)
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
30-Day All-Cause Readmission Rate, % of high-risk discharges with outreach within 48 hours
Coordinate across care providers at the point of care.
All Lines of Business
Deliver Whole Person Care
Medium
Analyze the impact and success of your program.
Return to tactics
Tactic: Implement a Complex Care Management strategy
Proactively identify and intensively manage your highest-risk members.
Workflows
What Success Looks Like
Impact is realized when the highest-risk, highest-cost members are precisely identified and managed through interdisciplinary model that addresses clinical, behavioral, and social drivers of instability, resulting in sustained reductions in avoidable utilization and improved long-term stability.
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
See workflows from Transitions of Care Tactic 1
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
Reduced ED visits, lower readmissions, better quality scores, improved member experience
All Lines of Business
Deliver Whole Person Care
Medium
Return to tactics
Tactic: Support patients with medication management
Ensuring patients have understanding, access, and adherence to appropriate medications.
Workflows
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
What Success Looks Like
Strong medication management is evident when care teams proactively address barriers to understanding, access, and adherence, leading to sustained clinical control and reduced utilization.
See workflows from Transitions of Care Tactic 1
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
Reduced avoidable events, fewer adverse drug events
All Lines of Business
Deliver Whole Person Care
Medium
Return to tactics
Tactic: Support aging in place / EOL
Deliver coordinated, preference-aligned care for seniors.
What Success Looks Like
Workflows
This strategy is effective when seniors have documented goals of care, initiative-taking advance care planning, and coordinated home- and community-based support that allows them to remain safely in their preferred setting. Performance is reflected in reduced unwanted hospitalizations, appropriate hospice utilization, and care delivery that aligns with patient and family preferences.
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
See workflows from Transitions of Care Tactic 1
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
Reduced avoidable acute care, lower end-of-life cost utilization
All Lines of Business
Deliver Whole Person Care
Long
Return to tactics
Tactic: Deploy proactive Disease Management
Close chronic condition gaps through data-driven outreach.
Workflows
What Success Looks Like
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
Disease management is working as intended chronic care gaps are consistently identified, prioritized, and addressed through coordinated outreach. This leads to improved HEDIS and quality performance, better risk capture alignment, and fewer avoidable exacerbations.
See workflows from Transitions of Care Tactic 1
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
Improved chronic condition performance (HEDIS/Stars): ex. HbA1C control < 8 or 9%, BP control <140/90
All Lines of Business
Deliver Whole Person Care
Medium
Return to tactics
Tactic: Address Social Determinants of Health (SDoH)
Identify and mitigate social barriers to care.
Workflows
What Success Looks Like
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
Social barriers are systematically addressed when screening is integrated into care workflows and identified needs are connected to accountable community resources. The result is greater patient stability, improved engagement, and measurable reductions in preventable utilization.
See workflows from Transitions of Care Tactic 1
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
% of Attributed Members Screened for SDOH Needs, % of Identified Needs Successfully Connected to Community Resources, Improved total cost of care outcomes
All LInes of Business
Deliver Whole Person Care
Long
Return to tactics
Tactic: Integrate and Coordinate Behavioral Health
Embed behavioral health into primary and complex care workflows.
Workflows
What Success Looks Like
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
High-performing organizations integrate behavioral health when care teams proactively identify behavioral health needs and manage them within the broader care plan. The result is reduced fragmentation, improved chronic condition management, and moderated total cost of care.
See workflows from Transitions of Care Tactic 1
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
% of Attributed Members Screened for Behavioral Health Conditions, % of Members with Positive Screens Receiving Timely Follow-Up, ED Visit, or Inpatient Utilization Rate Among Members with Behavioral Health Diagnoses
All Lines of Business
Deliver Whole Person Care
Long
Return to tactics
Workflow: Stratify your population and identify impactable patients
Steps for Action
Tips for Success
During Care Management implementation, you will partner with your Solution Delivery Consultant to define program eligibility criteria aligned to your organizational goals. Here is how this would take shape within a Transitions of Care program.
1. Navigate to the ADT Registry.
This registry provides near real-time Admit, Discharge, and Transfer (ADT) data, enabling care teams to identify recently discharged patients who may require follow-up.
2. Apply filters aligned to your TOC program criteria. Common filters include: Line of Business (LOB), Discharge Date, Discharge Disposition. Determining TOC Program Impact
- Does this list accurately represent the intended Transitions of Care population?
- Is the projected volume aligned with our team’s current capacity to deliver timely outreach?
- What adjustments to inclusion criteria would better balance impact and feasibility?
1. Layer risk scoring onto ADT feeds and focus on clinically and socially complex patients rather than enrolling every discharge.
2. Target reachable patients with modifiable risk aligned to contract priorities. 3. Ensure stratification supports readmissions reduction, total cost of care, and Stars performance. 4. Match high-risk volume to care team bandwidth to prevent overload. 5. Monitor contact rates, utilization trends, and ROI, adjusting thresholds as needed.
See Visuals
Recommended Next Action
1. Before implementing changes to TOC enrollment criteria: Deploy updated stratification rules in a UAT (User Acceptance Testing) environment, Compare enrollment volume under current vs. proposed logic. 2. Evaluate differences in: Risk score distribution, Attribution to risk contracts, Historical readmission rates, Projected care manager capacity impact Identify unintended consequences (e.g., sudden volume spikes, exclusion of key populations) 3. Action: Approve stratification updates only after validating expected enrollment yield and operational feasibility.
Line of Business
Maturity
Tag
Product Module
Provider; Payer
Low
Care Management
All Lines of Business
Workflow: Enroll and outreach to your population
Tips for Success
Steps for Action
Use risk and urgency to guide default enrollment status.
Focus outreach intensity on the most impactable patients. Standardize when and how patients move from Identified to Enrolled. Monitor outreach timeliness and contact yield. Balance caseloads to prevent bottlenecks.
This example illustrates how one organization aligned enrollment statuses to the key phases of the care management lifecycle:
Phase 1 Identified: Patients who meet program eligibility criteria are flagged but have not yet confirmed participation. Phase 2 Enrolled: Status advances after successful outreach and confirmed engagement (e.g., opt-in, pending assessment, active care plan monitoring). Phase 3 Discharged: Episode closes due to completion, opt-out, or other defined closure reasons. Viewing & Managing Status Enrollment status is managed within the Patient Chart (Enrollment & Supplementary card), where care teams can:
- View program participation and status history
- Update enrollment status as engagement progresses
Outreach Outreach aligns to the organization’s operating model:
- Nurse Care Manager–led outreach
- Care Coordinator–led outreach with nurse escalation
Before contacting the patient, the assigned team member reviews the patient’s chart (and EMR when appropriate) to understand clinical context. All outreach attempts — calls, texts, or mail — are documented and tracked. During implementation, enrollment triggers and status definitions should be configured to align with organizational goals and care team capacity.
Recommended Next Action
1. Audit worklists to confirm enrollment status, outreach activity, and documentation align.
2. Spot-check Identified and Enrolled patients for timely outreach. 3. Validate that Enrolled reflects true engagement. 4. Identify patients with no documented outreach. 5. Review caseload distribution across staff. 6. Update rules, clarify criteria, or rebalance workload as needed.
See Visuals
Line of Business
Maturity
Tag
Product Module
Provider; Payer
Medium
Care Management; Engage
All Lines of Business
Workflow: Coordinate Care Management operations and workloads
Steps for Action
Tips for Success
During implementation, you will partner with your Solution Delivery Consultant to define program role assignments aligned to your organizational goals. 1. Define Assignment Structure During implementation, configure role assignments and routing logic aligned to organizational priorities. Before automating, assess current care team capacity and workload distribution to ensure assignment rules are realistic and sustainable. 2. Monitor Workload Performance (Vista: Care Management Operations – Task Detail Tab) Use the dashboard to evaluate:
- Overall task volume, completion rates, overdue tasks, and average time per task
- Most common task types
- Outreach methods and time spent by method
- Individual staff workload and timeliness
These insights help leaders align staffing levels with program demand and identify workflow gaps. 3. Support Frontline Execution Care managers can use:
- CM Patients: View assigned patients, enrollment status, and recent utilization
- Notification & Task Feed: Monitor recent activity requiring follow-up
- Calendar Widget: Plan and track daily task completion
1. Configure assignment rules to reflect acuity, urgency, and intervention level.
2. Balance panels by both volume and patient complexity. 3. Set realistic capacity thresholds based on staffing availability. 4. Maintain continuity when possible, but rebalance when needed. 5. Use automation with regular oversight to prevent bottlenecks.
Recommended Next Action
1. Define clear timeframes for patient assignment (e.g., 24–48 hours).
2. Assign ownership for monitoring queues. 3. Clarify responsibility for panel rebalancing. 4. Establish a simple escalation path for delays. 5. Formalize SLAs to ensure timely assignment and prevent stagnant enrollments.
See Visuals
Line of Business
Maturity
Tag
Product Module
Provider; Payer
Medium
Care Management
All Lines of Business
Workflow: Document your Assessment and Care Plan (goals + interventions)
Steps for Action
1. Configure Assessments with Intent
- During implementation, define assessments aligned to program goals. Include only questions that directly support care planning, reporting, or contractual requirements (e.g., intake, chronic disease, SDOH, depression screening).
- Avoid unnecessary fields that add burden without influencing care decisions.
2. Configure Goals & Interventions
- Align goals and interventions to meaningful, actionable care plan steps.
- Leverage automation to trigger relevant goals and interventions based on assessment responses (e.g., depression screening → behavioral health goal; medication gap → adherence intervention).
- Focus on measurable, patient-centered actions that influence next steps.
3. Documentation in Action
- From the Patient Summary, initiate a New Task (Assessment, Care Plan Review, Med Rec, or Note).
- If completing an assessment:Select the appropriate assessment, Assign the task (self or team member), Start immediately or schedule for later
- Complete assessment sections sequentially or navigate as needed.
- Save as draft or complete when finished.
- If goals/interventions are triggered: Review suggested items, Add relevant goals and interventions to the Care Plan
4. Manage the Care Plan
- Through the CM tab, care teams can: View and update goals and interventions, Add barriers (e.g., financial, transportation), Assign new interventions, Edit or close care plan items
- This keeps: The intent behind documentation, Assessment configuration guidance, Automation logic, Task initiation steps, Care plan curation, Ongoing management, but removes repetition, UI over-description, and instructional filler.
Tips for Success
1. Include only assessment questions, goals, and interventions that directly support care planning or reporting needs.
2. Use automation to trigger relevant goals, tasks, and notifications to reduce manual effort. 3. Ensure goals are measurable, patient-centered, and clearly assigned. 4. Standardize expectations for assessment completion, status updates, and barrier documentation. 5. Promote timely, real-time documentation and routine care plan updates.
Recommended Next Action
1. Track required assessment completion rates by program 2. Monitor time from enrollment to initial assessment 3. Measure how often triggered goals are added to care plans 4. Review goal updates, closures, and stale plans 5. Identify documentation variation across team members
See Visuals
Line of Business
Maturity
Tag
Product Module
Provider; Payer
Medium
Care Management
All Lines of Business
Workflow: Coordinate across care providers at the point of care
Steps for Action
Tips for Success
The patient’s care plan should be integrated into the broader medical record and shared with the Primary Care Provider (PCP). Keeping the PCP informed ensures coordinated care, reinforces alignment across the care team, and supports clinical oversight.
The Care Plan can be shared in several ways.
1. Tagged to the Care Plan
- If a provider has access to Arcadia, they can be added to the Care Plan to receive notifications and updates.
- While Primary Care Providers (PCPs) do not typically have direct access to the Care Management tool, other members of the extended care team – such as Social Workers or Dietitians – may be granted access and included for coordination purposes.
2. Share the Care Plan
- Export or download the Care Plan from the Patient Summary (Print, PDF, or template export) to send to the PCP or upload to the EMR.
- Copy a summarized version using the Summarize feature for documentation directly in the EMR.
- The Patient Summary has the “Summarize” card available to copy/paste to the PCPs EMR (Summarize uses generative AI and integrates multiple LLMs, using data inputs from the Arcadia tool). Go to Summarize, choose the applicable summary and copy.
3. Surface at the Point of Care
- Use Inform within the EHR to view Care Management enrollments, assessments, and care plans. Encourage providers to review care management context during the visit to support aligned clinical decisions.
- Launch the Inform App and choose Care Management.
- Look for specific Assessments and Plans from the Care Manager for a detailed view.
1. Ensure care plans are visible within the clinical workflow, not siloed.
2. Define clear ownership for sharing and updating care plans. 3. Standardize how care plans are exported or documented in the EMR. 4. Encourage providers to incorporate care management insights into visits. 5. Create a feedback loop to reinforce coordination.
Recommended Next Action
1. Track care plan access, downloads, or acknowledgments (where feasible). 2. Measure follow-up actions tied to shared care plans. 3. Compare outcomes for patients with vs. without provider engagement. 4. Identify variation across provider groups. Action: Use engagement data to refine your sharing strategy, reinforce expectations with providers, and strengthen point-of-care integration.
See Visuals
Line of Business
Maturity
Tag
Product Module
Care Management; Patient Chart; Inform
Provider; Payer
High
All Lines of Business
Workflow: Analyze the impact and success of your program
Tips for Success
Steps for Action
1. Define clear benchmarks (e.g., contact rate, task completion, time-to-assessment) before reviewing performance.
2. Connect operational metrics to total cost of care and contract outcomes. 3. Focus on variation across teams or risk tiers—not just averages. 4. Establish a consistent review cadence with defined action items. 5. Shift the conversation from enrollment volume to engagement impact.
The Vista: Operational Care Management Dashboard integrates Arcadia Care Management data with demographic and risk insights to provide a comprehensive view of program performance, member engagement, and operational efficiency.Designed for Care Management leaders, supervisors, and analysts, the dashboard enables monitoring of enrollment trends, staff workload, outreach effectiveness, and risk distribution to support data-driven decision-making and continuous program improvement. This dashboard helps answer key operational questions, including:
How many members are currently enrolled, and how have identified and enrolled populations trended over time?
- What is the average duration of enrollment prior to discharge?
- What is the most common discharge and opt-out reasons?
- What is the overall task completion rate, and where are overdue tasks concentrated?
- What is the volume of outreach attempts in the past 30 days, and what is the member contact rate?
- Which assessments are completed most frequently, and what patterns are emerging in responses?
- Where are the highest concentrations of clinical or social risk within the population?
Recommended Next Action
1. Establish a quarterly executive review using the Operational Care Management Dashboard to assess performance and strategic impact.
2. During each review:
- Compare enrollment trends to contract and financial targets
- Evaluate outreach yield and engagement by risk tier
- Assess workload distribution relative to panel growth
- Review discharge and opt-out trends
- Identify leading indicators of quality and cost performance
3. Conclude each review with 2–3 defined operational adjustments and assign clear executive ownership for follow-through.
See Visuals
Line of Business
Maturity
Tag
Product Module
Provider; Payer
Low
All Lines of Business
Vista
We’re actively developing this content to support meaningful conversations and practical adoption. Check back soon for more information.
Care Navigation
Engines: Arcadia Impact SuiteWorkflows: Tasking & Care Plans, 5x OOB Care Programs w Registries, AI Care Navigation Agents, Bidirect Patient Messaging*, AI Clinical Assistant* Analytics: SDoH Analytics, Productivity Reporting Content: MCG, Eventium (add-ons)
Scale personalized care delivery
Care Navigation brings together tasking, care planning, and patient engagement workflows to coordinate personalized care at scale. It equips care teams with AI-driven navigation tools, bi-directional patient messaging, and structured care plan management to improve adherence, satisfaction, and outcomes. With add-ons like MCG and Eventium, this pack extends into clinical pathway management and SDoH analytics, bridging insights and action for front-line care teams. Transforms care teams from reactive case managers into proactive navigators.
* Base fee has ceiling on either users, usage, or services.
Care Navigation Sales Playbook
Key Performance Indicators
deliver whole person care
- Risk-Adjusted Inpatient Admits/1,000
- % admissions to preferred post-acute facilities
- % Transitional care management (TCM) opportunities completed
- Care manager productivity
Provider Persona
Pain Points
Lisa, VP Care Management
- Low yield patient outreach
- Fragmented systems with necessary information in many places
- Inefficiencies in reaching patients or deploying a care plan
- Unclear department success metrics to justify CM
- Lack of goal definition among quality improvement, disease management, long term case management
- Inadequate social and behavioral supports
NorthStar Health System (MSSP, MA,and Commmercial VBC contracts)
What Lisa needs Arcadia to Deliver
- Prioritized patient insights with clear interventions and success criteria
- Out of box and modifiable care management workflows
- Staff effectiveness tracking
engaging key stakeholders
Payer Stakeholders
Delivering Whole Person Care requires coordination across clinical, operational, and community-facing teams.
Roles that commonly influence progress
- VP Population Health, VP Clinical Operations, Medical Directors, Care Management Executives, Quality Leaders
What typically matters most in conversations
Use this section to anticipate which stakeholders influence care management strategy and tailor how you frame value to drive alignment and sustainable adoption.
- Reducing readmissions and total cost of care
- Improving Stars and quality performance
- Engaging high-risk members effectively
- Demonstrating measurable ROI from care management programs
Provider Stakeholders
How to frame value
Roles that commonly influence progress
- Chief Medical Officer, VP Population Health, Care Management Leadership, Primary Care Leaders, Behavioral Health Directors
- Connect care management workflows to financial performance and contract benchmarks
- Emphasize measurable impact on utilization and quality outcomes
- Position Arcadia as infrastructure that scales coordination across the risk pyramid
What typically matters most in conversations
- Strategically deploying care management programs
- Transitions of care
- Disease/Complex care management
- Medication Management
- End of Life
- SDOH
- Behavioral Health
What to be mindful of
- Difficulty demonstrating short-term ROI
- Over-enrollment without clear targeting strategy
- Operational variation across provider groups
How to frame value
More Persona Resources
- Position Whole Person Care as stabilizing high-risk patients and protecting provider time
- Emphasize proactive coordination that prevents downstream crises
- Highlight visibility across settings—not added documentation burden
Check out the User Persona Tab for more examples on Personas for this Driver.
What to be mindful of
- Care team bandwidth constraints
- Documentation fatigue
- Fragmented workflows between EMR, care management, and community partners
Analytics, IT & IS
Scale, security & automation for enterprise data management
Analytics: "Push" Scorecards*, AI Analytics Copilot*Dev Tools: Foundry Workbench, AI/ML Dev Factory*, Self-Service Registries, Self-Service Analytics SDK, Self-Service ETL SDKs* Data Mgmt: Reference Data Library, FHIR Server, Lake Sync*
The Analytics, IT & IS pack is built for technical and analytic teams that need to scale enterprise-grade infrastructure. It includes the Foundry Workbench, self-service analytics SDKs, FHIR Server, and tools for AI/ML-driven development. Organizations use this pack to automate data pipelines, empower analysts with self-service tools, and integrate AI across workflows securely and efficiently. For teams who want Arcadia’s platform to power their own analytics ecosystem.
* Base fee has ceiling on either users, usage, or services.
Analytics, IT & IS Sales Playbook
In high-performing organizations:
what "good" looks like
- High-risk and rising-risk members are proactively identified using clinical, utilization, and social risk signals
- Outreach is targeted and personalized to those members
- Engagement is clearly defined, targeted, and aligned to contract priorities. For example:
- Transitions of care are consistently managed with timely outreach and follow-up
- Medication adherence and chronic disease gaps are monitored and addressed longitudinally
- Behavioral health and social needs are integrated into care plans — not managed in isolation
- Resources are deployed where they drive the greatest clinical and financial impact
- Care plans are visible to and coordinated with providers at the point of care
- Workflows are automated where appropriate to reduce administrative burden
- Performance is continuously measured across utilization, quality, and financial outcomes. Following graduation, resources are re-allocated to new members.
High-performing organizations share a few common characteristics.
Use this section to illustrate how performance strengthens as Whole Person Care capabilities evolve over time.
Whole Person Care performance strengthens over time. Progress comes from early identification of high-risk, impactable patients, consistent outreach, coordinated care planning, and longitudinal follow-through.
Reassure customers that improvement is incremental and achievable.
Moving from discussion to action
Step 4: Align on the Success Signal for the Tactic
Turn insight into momentum
Connect the action to one or two Key Performance Indicators that will indicate progress.
- 30-Day All-Cause Readmission Rate
- % of high-risk discharges with outreach within 48 hours
- Reduced ED visits
- Improved quality scores
- Improved member experience
- Fewer adverse drug events
- Reduced avoidable acute care
- Lower end-of-life spend
- Improved chronic condition performance (HEDIS/Stars)
- % of attributed members screened for SDoH needs
- % of identified needs successfully connected to community resources
- Improved total cost of care outcomes
- % of attributed members screened for behavioral health conditions
- % of members with positive screens receiving timely follow-up
Step 1: Confirm the Focus Area
Anchor a next action with a specific opportunity, not a general goal.Examples:
- A high-risk cohort with recent ED visits and no documented follow-up
- A transition-of-care workflow with delayed outreach
- A population with low medication adherence or uncontrolled chronic conditions
- Members with documented social needs
Step 2: Connect to the Driver Tactics
Link the next action back to one or two core tactics from this driver, such as:
- Deploy a unified care team to manage transitions of care
- Implement a Complex Care Management strategy
- Support patients with medication management
- Support aging in place / EOL
- Deploy proactive Disease Management
- Address Social Determinants of Health (SDOH)
- Integrate and Coordinate Behavioral Health
Step 5: Align on a Clear Commitment Before Closing
Before closing, confirm one concrete commitment:
- What will be reviewed, configured, or launched
- Who is responsible
- When progress will be revisited
Step 3: Identify the Supporting Workflows for the Tactic
After the conversation:
Confirm which Arcadia workflows or tools will be used to support the next action.
- Align with Customer Success, Value Enablement, or Product on the selected focus area
- Share a relevant resource or walkthrough with the customer
- Prepare a focused view for the next discussion
- Revisit the tactics and workflows tab for this driver here.
- View the Tactics & Workflows Resource for Deliver Whole Person Care
Arcadia Essentials
Engines: CMS eCQM Measures, HCC/HHS Risk Models, Med Econ Engine & Claims GroupersWorkflows: User Hub (incl. SSO), 5x Core Registries, 5x Dashboards, Longitudinal Patient 360, Tasking & Documentation, AI Clinical Assistant Analytics: Foundry Data Warehouse, Dashboard Development Suite Data: CPT/UBREV, Medispan, CCS, Add'l Base Reference Data
Foundational capabilities for ACOs and health systems
Arcadia Essentials establishes the core data and analytics foundation for any value-based care engagement. It provides the baseline infrastructure — including claims normalization, clinical data integration, quality measures, longitudinal patient records, and population dashboards — that power all higher-tier workflows. Essentials enables health systems and ACOs to manage patient populations, monitor performance, and identify improvement opportunities with a single source of truth. It includes the AI Chart Summarization / Assistant for summarization and insight generation within chart review workflows.
* Base fee has ceiling on either users, usage, or services.
Arcadia Essentials - Product Sales Playbook
Deliver Whole Person Care
Shannon Ernst
Created on March 16, 2026
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Transcript
Delivering Whole Person Care means coordinating medical, behavioral, functional, and social needs across time — not just addressing isolated visits or conditions. It shifts organizations from a reactive, encounter-based model to a proactive, longitudinal approach that anticipates risk, stabilizes patients, and strengthens outcomes across the continuum of care.
Introduction to Driver
Deliver Whole Person Care
Tactics & Workflows
User Personas
Delivering Whole Person Care enables high-value, coordinated care by supporting teams in proactively managing medical, behavioral, and social needs—reducing avoidable utilization, stabilizing high-risk patients, and improving outcomes.
Why It Matters
Fragmented care drives avoidable admissions, readmissions, emergency department use, and unmanaged total cost of care, directly impacting performance in Medicare Advantage, MSSP, and other risk-bearing contracts.
Product Package
Enablement
Without coordinated longitudinal support, patients struggle with adherence, follow-up, behavioral health needs, and social barriers, undermining chronic disease control and destabilizing outcomes.
Resources
Click to View the Full Industry Context Handbook
Key Insight
Organizations that operationalize structured care management — including transitions oversight, chronic disease management, medication optimization, and social needs integration — consistently reduce avoidable utilization while improving quality performance and financial sustainability.
How Do We Operationalize This Driver?
Introduction to Driver
Deliver Whole Person Care
These tactics make care coordination structured and actionable across teams. Organizations can proactively identify, engage, and stabilize patients where fragmentation and avoidable risk are greatest.
Tactics & Workflows
Click into each of the tactics below to learn more and view its workflows.
User Personas
Improving quality performance enables the delivery of high-value, evidence-based care by supporting PCPs and specialists in closing care gaps, reducing complications, and improving outcomes.
Implement a Complex Care Management strategy
Deploy a unified care team to manage transitions of care
Support patients with medication management
Product Package
Enablement
Deploy proactive Disease Management
Support aging in place / EOL
Address Social Determinants of Health (SDOH)
Resources
Integrate and Coordinate Behavioral Health
Click to View the Full Tactic & workflows handbook
Who Should We Engage and How?
Introduction to Driver
Delivering Whole Person Care requires coordinated engagement across clinical, operational, and community-facing roles. Success depends on aligning care managers, primary care, specialists, pharmacists, and social support teams around shared accountability for longitudinal patient outcomes.
Deliver Whole Person Care
Tactics & Workflows
User Personas
Improving quality performance enables the delivery of high-value, evidence-based care by supporting PCPs and specialists in closing care gaps, reducing complications, and improving outcomes.
Providers
Provider Persona Example
Product Package
Enablement
Resources
Payers
More Persona Resources
Introduction to Driver
Deliver Whole Person Care
What Solutions Support This Driver?
Tactics & Workflows
Delivering Whole Person Care requires integrated data, coordinated workflows, and purpose-built care management capabilities that enable proactive, longitudinal patient engagement across settings.
User Personas
Improving quality performance enables the delivery of high-value, evidence-based care by supporting PCPs and specialists in closing care gaps, reducing complications, and improving outcomes.
Product Package
Analytics, IT & IS
Care Navigation
Arcadia Essentials
Enablement
Scale, security & automation for enterprise data management
Scale personalized care delivery
Foundational capabilities for ACOs and health systems
Resources
Value Add
Core
Value Add
Product Package Resources
Introduction to Driver
How Do We Connect Value to Action?
Deliver Whole Person Care
This guidance helps customer-facing teams connect the Deliver Whole Person Care driver to customer priorities, align cross-functional stakeholders, and advance adoption using Arcadia’s care management, analytics, and coordination workflows.
Tactics & Workflows
Guiding Customer Conversations
User Personas
Improving quality performance enables the delivery of high-value, evidence-based care by supporting PCPs and specialists in closing care gaps, reducing complications, and improving outcomes.
The tools below support productive conversations, establish shared expectations, and move discussions toward clear next steps. Click the tiles below to learn more.
Product Package
Discovery Questions
Engaging Key Stakeholders
What "Good" Looks Like
Moving From Discussion to Action
Enablement
Resources
Implementation & Configuration Guidance
This resource supports implementation and configuration decisions for customers advancing Whole Person Care. The handbook highlights key considerations, workflow design choices, and early scoping questions to help teams align automation, documentation, and reporting to real care management use cases.
Click to View the Implementation & Configuration handbook
What Resources Support This Work?
Introduction to Driver
Deliver Whole Person Care
Explore guides, tools, and learning resources that support the Deliver Whole Person Care Driver.
Tactics & Workflows
Drivers of Success Source of Truth
User Personas
Improving quality performance enables the delivery of high-value, evidence-based care by supporting PCPs and specialists in closing care gaps, reducing complications, and improving outcomes.
Deliver Whole Person Care Driver Handbooks
Product Package
Enablement
Product Package Resources
Resources
LMS Resources
Workflows
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
Tactic: Deploy a unified care team to manage transitions of care
Stratify your population and identify impactable patients.
Establishing early alerts and notifications of necessary transitions of care allows the care team maximum impact.
Enroll and outreach to your population.
What Success Looks Like
Success is achieved when transitions of care are proactively identified and managed through a coordinated, accountable care team, ensuring no patient is lost during high-risk handoffs. This results in measurable reductions in avoidable utilization, improved patient experience, and stronger performance under value-based contracts.
Coordinate Care Management operations and workloads.
Document your Assessment and Care Plan (goals + interventions)
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
30-Day All-Cause Readmission Rate, % of high-risk discharges with outreach within 48 hours
Coordinate across care providers at the point of care.
All Lines of Business
Deliver Whole Person Care
Medium
Analyze the impact and success of your program.
Return to tactics
Tactic: Implement a Complex Care Management strategy
Proactively identify and intensively manage your highest-risk members.
Workflows
What Success Looks Like
Impact is realized when the highest-risk, highest-cost members are precisely identified and managed through interdisciplinary model that addresses clinical, behavioral, and social drivers of instability, resulting in sustained reductions in avoidable utilization and improved long-term stability.
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
See workflows from Transitions of Care Tactic 1
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
Reduced ED visits, lower readmissions, better quality scores, improved member experience
All Lines of Business
Deliver Whole Person Care
Medium
Return to tactics
Tactic: Support patients with medication management
Ensuring patients have understanding, access, and adherence to appropriate medications.
Workflows
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
What Success Looks Like
Strong medication management is evident when care teams proactively address barriers to understanding, access, and adherence, leading to sustained clinical control and reduced utilization.
See workflows from Transitions of Care Tactic 1
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
Reduced avoidable events, fewer adverse drug events
All Lines of Business
Deliver Whole Person Care
Medium
Return to tactics
Tactic: Support aging in place / EOL
Deliver coordinated, preference-aligned care for seniors.
What Success Looks Like
Workflows
This strategy is effective when seniors have documented goals of care, initiative-taking advance care planning, and coordinated home- and community-based support that allows them to remain safely in their preferred setting. Performance is reflected in reduced unwanted hospitalizations, appropriate hospice utilization, and care delivery that aligns with patient and family preferences.
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
See workflows from Transitions of Care Tactic 1
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
Reduced avoidable acute care, lower end-of-life cost utilization
All Lines of Business
Deliver Whole Person Care
Long
Return to tactics
Tactic: Deploy proactive Disease Management
Close chronic condition gaps through data-driven outreach.
Workflows
What Success Looks Like
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
Disease management is working as intended chronic care gaps are consistently identified, prioritized, and addressed through coordinated outreach. This leads to improved HEDIS and quality performance, better risk capture alignment, and fewer avoidable exacerbations.
See workflows from Transitions of Care Tactic 1
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
Improved chronic condition performance (HEDIS/Stars): ex. HbA1C control < 8 or 9%, BP control <140/90
All Lines of Business
Deliver Whole Person Care
Medium
Return to tactics
Tactic: Address Social Determinants of Health (SDoH)
Identify and mitigate social barriers to care.
Workflows
What Success Looks Like
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
Social barriers are systematically addressed when screening is integrated into care workflows and identified needs are connected to accountable community resources. The result is greater patient stability, improved engagement, and measurable reductions in preventable utilization.
See workflows from Transitions of Care Tactic 1
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
% of Attributed Members Screened for SDOH Needs, % of Identified Needs Successfully Connected to Community Resources, Improved total cost of care outcomes
All LInes of Business
Deliver Whole Person Care
Long
Return to tactics
Tactic: Integrate and Coordinate Behavioral Health
Embed behavioral health into primary and complex care workflows.
Workflows
What Success Looks Like
To apply Arcadia data to your strategy across this tactic, we recommend the following workflows.
High-performing organizations integrate behavioral health when care teams proactively identify behavioral health needs and manage them within the broader care plan. The result is reduced fragmentation, improved chronic condition management, and moderated total cost of care.
See workflows from Transitions of Care Tactic 1
Line Of Business Relevancy
KPI to Measure Success
Time to Value
Driver
% of Attributed Members Screened for Behavioral Health Conditions, % of Members with Positive Screens Receiving Timely Follow-Up, ED Visit, or Inpatient Utilization Rate Among Members with Behavioral Health Diagnoses
All Lines of Business
Deliver Whole Person Care
Long
Return to tactics
Workflow: Stratify your population and identify impactable patients
Steps for Action
Tips for Success
During Care Management implementation, you will partner with your Solution Delivery Consultant to define program eligibility criteria aligned to your organizational goals. Here is how this would take shape within a Transitions of Care program. 1. Navigate to the ADT Registry. This registry provides near real-time Admit, Discharge, and Transfer (ADT) data, enabling care teams to identify recently discharged patients who may require follow-up. 2. Apply filters aligned to your TOC program criteria. Common filters include: Line of Business (LOB), Discharge Date, Discharge Disposition. Determining TOC Program Impact
1. Layer risk scoring onto ADT feeds and focus on clinically and socially complex patients rather than enrolling every discharge. 2. Target reachable patients with modifiable risk aligned to contract priorities. 3. Ensure stratification supports readmissions reduction, total cost of care, and Stars performance. 4. Match high-risk volume to care team bandwidth to prevent overload. 5. Monitor contact rates, utilization trends, and ROI, adjusting thresholds as needed.
See Visuals
Recommended Next Action
1. Before implementing changes to TOC enrollment criteria: Deploy updated stratification rules in a UAT (User Acceptance Testing) environment, Compare enrollment volume under current vs. proposed logic. 2. Evaluate differences in: Risk score distribution, Attribution to risk contracts, Historical readmission rates, Projected care manager capacity impact Identify unintended consequences (e.g., sudden volume spikes, exclusion of key populations) 3. Action: Approve stratification updates only after validating expected enrollment yield and operational feasibility.
Line of Business
Maturity
Tag
Product Module
Provider; Payer
Low
Care Management
All Lines of Business
Workflow: Enroll and outreach to your population
Tips for Success
Steps for Action
Use risk and urgency to guide default enrollment status. Focus outreach intensity on the most impactable patients. Standardize when and how patients move from Identified to Enrolled. Monitor outreach timeliness and contact yield. Balance caseloads to prevent bottlenecks.
This example illustrates how one organization aligned enrollment statuses to the key phases of the care management lifecycle: Phase 1 Identified: Patients who meet program eligibility criteria are flagged but have not yet confirmed participation. Phase 2 Enrolled: Status advances after successful outreach and confirmed engagement (e.g., opt-in, pending assessment, active care plan monitoring). Phase 3 Discharged: Episode closes due to completion, opt-out, or other defined closure reasons. Viewing & Managing Status Enrollment status is managed within the Patient Chart (Enrollment & Supplementary card), where care teams can:
- View program participation and status history
- Update enrollment status as engagement progresses
Outreach Outreach aligns to the organization’s operating model:- Nurse Care Manager–led outreach
- Care Coordinator–led outreach with nurse escalation
Before contacting the patient, the assigned team member reviews the patient’s chart (and EMR when appropriate) to understand clinical context. All outreach attempts — calls, texts, or mail — are documented and tracked. During implementation, enrollment triggers and status definitions should be configured to align with organizational goals and care team capacity.Recommended Next Action
1. Audit worklists to confirm enrollment status, outreach activity, and documentation align. 2. Spot-check Identified and Enrolled patients for timely outreach. 3. Validate that Enrolled reflects true engagement. 4. Identify patients with no documented outreach. 5. Review caseload distribution across staff. 6. Update rules, clarify criteria, or rebalance workload as needed.
See Visuals
Line of Business
Maturity
Tag
Product Module
Provider; Payer
Medium
Care Management; Engage
All Lines of Business
Workflow: Coordinate Care Management operations and workloads
Steps for Action
Tips for Success
During implementation, you will partner with your Solution Delivery Consultant to define program role assignments aligned to your organizational goals. 1. Define Assignment Structure During implementation, configure role assignments and routing logic aligned to organizational priorities. Before automating, assess current care team capacity and workload distribution to ensure assignment rules are realistic and sustainable. 2. Monitor Workload Performance (Vista: Care Management Operations – Task Detail Tab) Use the dashboard to evaluate:
- Overall task volume, completion rates, overdue tasks, and average time per task
- Most common task types
- Outreach methods and time spent by method
- Individual staff workload and timeliness
These insights help leaders align staffing levels with program demand and identify workflow gaps. 3. Support Frontline Execution Care managers can use:1. Configure assignment rules to reflect acuity, urgency, and intervention level. 2. Balance panels by both volume and patient complexity. 3. Set realistic capacity thresholds based on staffing availability. 4. Maintain continuity when possible, but rebalance when needed. 5. Use automation with regular oversight to prevent bottlenecks.
Recommended Next Action
1. Define clear timeframes for patient assignment (e.g., 24–48 hours). 2. Assign ownership for monitoring queues. 3. Clarify responsibility for panel rebalancing. 4. Establish a simple escalation path for delays. 5. Formalize SLAs to ensure timely assignment and prevent stagnant enrollments.
See Visuals
Line of Business
Maturity
Tag
Product Module
Provider; Payer
Medium
Care Management
All Lines of Business
Workflow: Document your Assessment and Care Plan (goals + interventions)
Steps for Action
1. Configure Assessments with Intent
- During implementation, define assessments aligned to program goals. Include only questions that directly support care planning, reporting, or contractual requirements (e.g., intake, chronic disease, SDOH, depression screening).
- Avoid unnecessary fields that add burden without influencing care decisions.
2. Configure Goals & Interventions- Align goals and interventions to meaningful, actionable care plan steps.
- Leverage automation to trigger relevant goals and interventions based on assessment responses (e.g., depression screening → behavioral health goal; medication gap → adherence intervention).
- Focus on measurable, patient-centered actions that influence next steps.
3. Documentation in Action- From the Patient Summary, initiate a New Task (Assessment, Care Plan Review, Med Rec, or Note).
- If completing an assessment:Select the appropriate assessment, Assign the task (self or team member), Start immediately or schedule for later
- Complete assessment sections sequentially or navigate as needed.
- Save as draft or complete when finished.
- If goals/interventions are triggered: Review suggested items, Add relevant goals and interventions to the Care Plan
4. Manage the Care PlanTips for Success
1. Include only assessment questions, goals, and interventions that directly support care planning or reporting needs. 2. Use automation to trigger relevant goals, tasks, and notifications to reduce manual effort. 3. Ensure goals are measurable, patient-centered, and clearly assigned. 4. Standardize expectations for assessment completion, status updates, and barrier documentation. 5. Promote timely, real-time documentation and routine care plan updates.
Recommended Next Action
1. Track required assessment completion rates by program 2. Monitor time from enrollment to initial assessment 3. Measure how often triggered goals are added to care plans 4. Review goal updates, closures, and stale plans 5. Identify documentation variation across team members
See Visuals
Line of Business
Maturity
Tag
Product Module
Provider; Payer
Medium
Care Management
All Lines of Business
Workflow: Coordinate across care providers at the point of care
Steps for Action
Tips for Success
The patient’s care plan should be integrated into the broader medical record and shared with the Primary Care Provider (PCP). Keeping the PCP informed ensures coordinated care, reinforces alignment across the care team, and supports clinical oversight. The Care Plan can be shared in several ways. 1. Tagged to the Care Plan
- If a provider has access to Arcadia, they can be added to the Care Plan to receive notifications and updates.
- While Primary Care Providers (PCPs) do not typically have direct access to the Care Management tool, other members of the extended care team – such as Social Workers or Dietitians – may be granted access and included for coordination purposes.
2. Share the Care Plan- Export or download the Care Plan from the Patient Summary (Print, PDF, or template export) to send to the PCP or upload to the EMR.
- Copy a summarized version using the Summarize feature for documentation directly in the EMR.
- The Patient Summary has the “Summarize” card available to copy/paste to the PCPs EMR (Summarize uses generative AI and integrates multiple LLMs, using data inputs from the Arcadia tool). Go to Summarize, choose the applicable summary and copy.
3. Surface at the Point of Care1. Ensure care plans are visible within the clinical workflow, not siloed. 2. Define clear ownership for sharing and updating care plans. 3. Standardize how care plans are exported or documented in the EMR. 4. Encourage providers to incorporate care management insights into visits. 5. Create a feedback loop to reinforce coordination.
Recommended Next Action
1. Track care plan access, downloads, or acknowledgments (where feasible). 2. Measure follow-up actions tied to shared care plans. 3. Compare outcomes for patients with vs. without provider engagement. 4. Identify variation across provider groups. Action: Use engagement data to refine your sharing strategy, reinforce expectations with providers, and strengthen point-of-care integration.
See Visuals
Line of Business
Maturity
Tag
Product Module
Care Management; Patient Chart; Inform
Provider; Payer
High
All Lines of Business
Workflow: Analyze the impact and success of your program
Tips for Success
Steps for Action
1. Define clear benchmarks (e.g., contact rate, task completion, time-to-assessment) before reviewing performance. 2. Connect operational metrics to total cost of care and contract outcomes. 3. Focus on variation across teams or risk tiers—not just averages. 4. Establish a consistent review cadence with defined action items. 5. Shift the conversation from enrollment volume to engagement impact.
The Vista: Operational Care Management Dashboard integrates Arcadia Care Management data with demographic and risk insights to provide a comprehensive view of program performance, member engagement, and operational efficiency.Designed for Care Management leaders, supervisors, and analysts, the dashboard enables monitoring of enrollment trends, staff workload, outreach effectiveness, and risk distribution to support data-driven decision-making and continuous program improvement. This dashboard helps answer key operational questions, including: How many members are currently enrolled, and how have identified and enrolled populations trended over time?
Recommended Next Action
1. Establish a quarterly executive review using the Operational Care Management Dashboard to assess performance and strategic impact. 2. During each review:
- Compare enrollment trends to contract and financial targets
- Evaluate outreach yield and engagement by risk tier
- Assess workload distribution relative to panel growth
- Review discharge and opt-out trends
- Identify leading indicators of quality and cost performance
3. Conclude each review with 2–3 defined operational adjustments and assign clear executive ownership for follow-through.See Visuals
Line of Business
Maturity
Tag
Product Module
Provider; Payer
Low
All Lines of Business
Vista
We’re actively developing this content to support meaningful conversations and practical adoption. Check back soon for more information.
Care Navigation
Engines: Arcadia Impact SuiteWorkflows: Tasking & Care Plans, 5x OOB Care Programs w Registries, AI Care Navigation Agents, Bidirect Patient Messaging*, AI Clinical Assistant* Analytics: SDoH Analytics, Productivity Reporting Content: MCG, Eventium (add-ons)
Scale personalized care delivery
Care Navigation brings together tasking, care planning, and patient engagement workflows to coordinate personalized care at scale. It equips care teams with AI-driven navigation tools, bi-directional patient messaging, and structured care plan management to improve adherence, satisfaction, and outcomes. With add-ons like MCG and Eventium, this pack extends into clinical pathway management and SDoH analytics, bridging insights and action for front-line care teams. Transforms care teams from reactive case managers into proactive navigators.
* Base fee has ceiling on either users, usage, or services.
Care Navigation Sales Playbook
Key Performance Indicators
deliver whole person care
Provider Persona
Pain Points
Lisa, VP Care Management
NorthStar Health System (MSSP, MA,and Commmercial VBC contracts)
What Lisa needs Arcadia to Deliver
engaging key stakeholders
Payer Stakeholders
Delivering Whole Person Care requires coordination across clinical, operational, and community-facing teams.
Roles that commonly influence progress
What typically matters most in conversations
Use this section to anticipate which stakeholders influence care management strategy and tailor how you frame value to drive alignment and sustainable adoption.
Provider Stakeholders
How to frame value
Roles that commonly influence progress
What typically matters most in conversations
What to be mindful of
How to frame value
More Persona Resources
Check out the User Persona Tab for more examples on Personas for this Driver.
What to be mindful of
Analytics, IT & IS
Scale, security & automation for enterprise data management
Analytics: "Push" Scorecards*, AI Analytics Copilot*Dev Tools: Foundry Workbench, AI/ML Dev Factory*, Self-Service Registries, Self-Service Analytics SDK, Self-Service ETL SDKs* Data Mgmt: Reference Data Library, FHIR Server, Lake Sync*
The Analytics, IT & IS pack is built for technical and analytic teams that need to scale enterprise-grade infrastructure. It includes the Foundry Workbench, self-service analytics SDKs, FHIR Server, and tools for AI/ML-driven development. Organizations use this pack to automate data pipelines, empower analysts with self-service tools, and integrate AI across workflows securely and efficiently. For teams who want Arcadia’s platform to power their own analytics ecosystem.
* Base fee has ceiling on either users, usage, or services.
Analytics, IT & IS Sales Playbook
In high-performing organizations:
what "good" looks like
High-performing organizations share a few common characteristics.
Use this section to illustrate how performance strengthens as Whole Person Care capabilities evolve over time.
Whole Person Care performance strengthens over time. Progress comes from early identification of high-risk, impactable patients, consistent outreach, coordinated care planning, and longitudinal follow-through.
Reassure customers that improvement is incremental and achievable.
Moving from discussion to action
Step 4: Align on the Success Signal for the Tactic
Turn insight into momentum
Connect the action to one or two Key Performance Indicators that will indicate progress.
Step 1: Confirm the Focus Area
Anchor a next action with a specific opportunity, not a general goal.Examples:
Step 2: Connect to the Driver Tactics
Link the next action back to one or two core tactics from this driver, such as:
Step 5: Align on a Clear Commitment Before Closing
Before closing, confirm one concrete commitment:
Step 3: Identify the Supporting Workflows for the Tactic
After the conversation:
Confirm which Arcadia workflows or tools will be used to support the next action.
Arcadia Essentials
Engines: CMS eCQM Measures, HCC/HHS Risk Models, Med Econ Engine & Claims GroupersWorkflows: User Hub (incl. SSO), 5x Core Registries, 5x Dashboards, Longitudinal Patient 360, Tasking & Documentation, AI Clinical Assistant Analytics: Foundry Data Warehouse, Dashboard Development Suite Data: CPT/UBREV, Medispan, CCS, Add'l Base Reference Data
Foundational capabilities for ACOs and health systems
Arcadia Essentials establishes the core data and analytics foundation for any value-based care engagement. It provides the baseline infrastructure — including claims normalization, clinical data integration, quality measures, longitudinal patient records, and population dashboards — that power all higher-tier workflows. Essentials enables health systems and ACOs to manage patient populations, monitor performance, and identify improvement opportunities with a single source of truth. It includes the AI Chart Summarization / Assistant for summarization and insight generation within chart review workflows.
* Base fee has ceiling on either users, usage, or services.
Arcadia Essentials - Product Sales Playbook