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Knowledge Center

One Platform. Endless Possibilities.

MedHOK’s Unified Payer Platform is establishing the new standard in the health plan and payer organization enterprise systems. Our unique ability to help transform health plans from the legacy fee-for service business model, to the new value-based healthcare model, is demonstrated by the success of our clients. MedHOK serves over 50 of the most relevant and highest rated plans in the industry. Among our clients, we boast the number one rated health plan in the country, the largest PBM in the country, the third largest health insurer in the country, the largest specialty dialysis insurer in the country, three large Blues plans, the largest multi-state Medicaid Plan in the country, the largest integrated delivery system in the nation and the largest standalone Rx Specialty company. Our clients, large and small, have improved their Star ratings to 4 and above, successfully passed their CMS, NCQA and State audits, improved operational efficiency and revenue realization. LEARN MORE about what these organizations know that is helping to drive their success in the new value-based healthcare era.


We’re happy to share our knowledge. Here’s some of the resources we think you’ll need to stay compliant.

Baseball, Apple Pie & Value-Based Healthcare

What seemed impossible, was possible. Learn how to make the “impossible” transformation to value-based healthcare by taking a different approach.


Mr. Health Plan CIO... Tear Down These Walls!

Monumental transformations are marked by monumental events. Health Plan CIO’s should heed the words of President Ronald Reagan to invigorate their organizations.


Moving The Needle On Member Engagement

Health plans are struggling to deliver impactful member engagement. Learn what is underming your efforts and what you can do to impactfully move the neddle.


How the Opposing Forces of Health Plan Business Models Can Create Stars

Health plans must balance the pressures of regulatory compliance and the need for business performance improvement. Learn how to harnes both of these forces to generate high Star Ratings.


Upcoming Webinars

Find out more about these amazing capabilities through these upcoming webinars.

  • Integrate Medical and Pharmacy Care
  • Ensure Compliance Adherence
  • Automate Workflows and Improve Efficiencies
  • Drive Pay for Quality Revenue Models
  • Facilitate Member Engagement
  • Enable Stakeholder Collaboration

MedHOK delivers the solution Health Plans and Payer Organizations need to succeed with value-based healthcare.

  • Solving Emerging Enrollment Compliance Challenges
  • MarketProminence Enrollment Portals
  • Compliance Timeliness Monitoring
  • Compliant & Profitable Model of Care for SNPs
  • Emerging Outreach Compliance Measures
  • Benefits of a Unified Payer Platform
  • Compliance EED, CN and PBP
  • Solving the Long-Term Services & Support (LTSS) Challenge
  • Baseball, Apple Pie & Value-Based Healthcare
  • Case Management Offline Assessments
  • HEDIS Global Stratification
  • Mr. Health Plan CIO – Tear Down These Walls
  • Moving the Needle on Member Engagement
  • MP Financial Reconciliation
  • Medical Therapy Management (MTM)
  • Provider Portal Clinical Profile
  • How Opposing Forces Create Stars (Ratings)
  • Marketing Misrepresentation

“Since we have implemented MedHOK, this is the first year I have quality of life.”
Medical Director, Large Health Plan

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