Arkos Health Care Management Support

Blue Cross Blue Shield of North Dakota (BCBSND) Medicaid Expansion is partnering with Arkos Health to enhance our support to Medicaid Expansion patients across the state of North Dakota.

Arkos is a population health management company that works with health insurers and patients’ primary care team to help provide supplemental coordinated care to Medicaid Expansion patients at no additional cost to the patient or provider.

This added support is all about meeting patients where they’re at and closing gaps where they may otherwise fall through the cracks.

In order for Arkos to best partner with providers, they have hired staff who can further assist with care management services. The program will start with a small team working across the state. Arkos team will include nurses, EMTs, and social workers under the direction of ND-based market president.

Services in support of Medicaid Expansion Patients

By serving as an extension of the primary care team, Arkos representatives will proactively engage Medicaid patients and walk with them through their care needs in alignment with their primary care practitioner. By walking with them, they can help improve quality, while managing costs leveraging virtual, mobile and in-home services. Through their work in other parts of the country, Arkos has proven to reduce unnecessary institutional spending for hospital admissions and emergency department visits and helped close critical gaps in care, such as monitoring in-home prescription medication adherence.

Example services:

• Engaging with patients after a hospital stay to ensure the patients filled their prescribed medications and made necessary follow-up visits with their primary care provider.
• Helping patients know where to go for care.
• Assessing and coordinating community resources.
• Helping patients comply with their prescribed treatment plan.
• Providing in-home palliative care services and in-home intensive care management.

Services in support of Medicaid Expansion Providers

Beyond the benefit of more care for the patient, Arkos services can also be an advantage to North Dakota providers who may need additional support to effectively coordinate and deliver high-quality care in accordance with BCBSND’s value-based program expectations.

Example services:

• Relieve provider of some administrative and care coordination work that can often be a challenge outside the clinic office, hospital or emergency room.
• Transitional care management, which coordinates care for patients following an acute inpatient admission.
• Emergency department coordination to help patients best determine when to use the ER.

Patients enrolled in Arkos

Arkos' services begin with the needs of the patient and can be referred by providers and BCBSND.

Patients may be referred because:

• Multiple emergency visits.
• Acute care admissions.
• Chronic conditions.
• New cancer diagnosis.
• Treatment regime.
• Low utilization of primary care providers and high utilization of specialists.
• Other triggers.

Once a patient is referred, Arkos will review referrals for opportunities for engagement. Once the patient agrees to use the services, we will collaborate with the provider to determine the best path forward.

Providers receiving inquiries from patients about Arkos can direct patients to their 24-hour care line at 844-442-7567. Medicaid Expansion patients not enrolled with Arkos can contact 833-777-5779.

If a provider refers a patient to an Arkos team, they are invited to the Arkos’ Interdisciplinary Care Team (ICT). Someone on the Arkos team will reach out with meeting credentials and date/time information.

Who to Contact/ Call with Questions?

North Dakota providers serving Medicaid Expansion patients may be assigned an Arkos Provider Relations partner. If you are unsure how to contact your partner or do not currently have a partner assigned, please call:

Arkos – Fargo Office: 844-397-5867

Ashley Sletten
Arkos – Director of Provider Relations: 701-960-0852