CLOSE SDOH GAPS
When Social Needs Go Unmet, Everyone Pays the Price.
As a Managed Care Organization (MCO), you know that addressing health is only part of the equation when it comes to supporting your members. Basically, it’s not just about doctors and diagnoses; it’s about having safe housing, access to food, transportation assistance, and more. These social determinants of health (SDOH) not only impact quality of life, but also significantly influence health outcomes and costs.
Challenges in Partnering with CBOs
Community-Based Organizations that provide services such as housing, food, and transportation are often fragmented, underfunded, and poorly integrated with healthcare systems. This leads to difficulties in coordinating care plans that extend beyond clinical services. Over 50% of MCOs report challenges in partnering with CBOs due to limited capacity or infrastructure (Health Affairs).
4.5x Higher Annual Healthcare Costs
Medicaid enrollees with two or more SDOH issues are three times more likely to visit the ER and incur healthcare costs that are up to 4.5 times higher compared to those without unmet social needs (JAMA Network Open, AJMC).
Inability to Follow Up
Staffing shortages in case management have increased by 22% in the past five years. Consequently, over 60% of case managers report being unable to follow up with all high-risk members, leading to gaps in care and preventable escalations (CMSA Today, Shearwater Health).
CLOSE GAPS. LOWER COSTS. IMPROVE OUTCOMES
Measurable Results That Matter to MCOs
Our platform empowers you to take decisive action without overwhelming already stretched teams — helping you close SDOH gaps, ease pressure on ERs, minimize readmissions, and boost STAR ratings through verified service delivery.
SEE THE VALUE OF CLOSING GAPS IN REAL TIME
KokuaNet: Cost vs Benefit Calculator for MCOs
Our interactive calculator helps Medicaid MCOs understand the true value of closing SDOH gaps. By entering your member population and average number of social needs, the tool estimates your total program cost using our pay-for-performance model. It then calculates projected healthcare savings — based on avoided ER visits, hospitalizations, and other costly outcomes — to show your net benefit and return on impact. It’s a clear, data-backed way to see how verified gap closure improves health outcomes and your bottom line.
Quickly calculate ROI by weighing the cost of closing SDOH gaps against projected savings from reduced high-cost care.
Estimated Results include
- Program Cost: Based on pay-for-performance pricing.
- Cost Avoidance: From reduced emergency room visits and readmissions.
- Net ROI: Total savings minus service costs.
- Equity Impact: Analyzed by zip code and demographic trends.
This calculator provides estimates only and does not represent a formal quote or guaranteed pricing.
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Pricing
Performance Based Pricing
We ONLY bill when the result is REAL
Low Risk Employee
$100/ Gap Closed
- Risk based on SDOH acuity
- Local CBO Match
- Service Date Confirmed
- Service Verified
Medium Risk Employee
$150/ Gap Closed
- Risk based on SDOH Acuity
- Local CBO Match
- Service Data Confirmed
- Service Verified
High Risk Employee
$200/ Gap Closed
- High Risk Patient
- Local CBO Match
- Service Date Confrimed
- Service Verified
