The leading community-based closed-loop referral platform for social care collaboration and Health-Related Social Needs reimbursement for state Medicaid Transformation.
Unite Us is uniquely prepared to meet HRSN 1115 Medicaid Waiver requirements on time. We are the leading social care technology provider operating accountable networks of screenings, closed-loop referrals, and automated Health-Related Social Needs (HRSN) reimbursement at scale.
Medicaid 1115 waivers grant states the flexibility to design and implement innovative strategies for their Medicaid managed care programs, with the goal of expanding access to quality care, improving health outcomes, and reducing costs. They facilitate stronger collaboration across health and social care by providing a stable funding stream for community-based organizations (CBOs) that provide critical HRSN services, such as housing, transportation, or food assistance, through Medicaid.
We combine robust technology solutions, deep technical and regulatory expertise, and strong community relationships to deliver the infrastructure that states need to bring HRSN 1115 Waiver programs to life, quickly and successfully.
Centered on community and designed with the end user in mind:
- Easy to use for all network partners from healthcare to government to CBOs
- Interoperability and process automation for streamlined workflows
- Centered around accountable community networks
Meet all data and IT waiver requirements
Our flexible and scalable solution suite meets all requirements for social care reimbursement and reporting, allowing you to move quickly and efficiently across the waiver ecosystem.
Eligibility and Enrollment
Streamline eligibility checks with an integrated, dynamic enrollment process.
Billing and Claims
Functionality
Automate HRSN service reimbursement and EDI 837 encounter reporting from one system.
Real-Time Reporting
Monitor, manage, and report on program enrollment, network adequacy, and revenue cycle.
Program Guardrails
Ensure program integrity with an enterprise-wide longitudinal care record and embedded program rules.
Reducing Duplication
Consolidate screening and documentation within a single enterprise-wide member profile.
Proven Success Across the Nation
Unite Us has a proven track record of powering Medicaid transformation programs in communities across the country.
North Carolina 
Oregon 
New York 
California North Carolina
Unite Us partners with the North Carolina Health Opportunities Pilot out of NC DHHS to serve as the technology backbone connecting health plans, network leads, providers, and public entities. Using Unite Us’ Social Care Payments product, providers in the state manage eligibility and authorization, send referrals to contracted providers, securely track outcomes and document services, generate EDI 837 claims, and efficiently manage reimbursement of social care services.
Key Stats
$87M+
reimbursed
2-3%
payer rejection rate vs. national rejection rate of 18%
455K+
services delivered to Medicaid members
98%
of referrals accepted in 2 days or less
Oregon
Unite Us partners with Medicaid Coordinated Care Organizations (CCOs) across Oregon for closed-loop referrals, providing the infrastructure to channel funding into local communities delivering HRSNs under Oregon’s 1115 waiver.
Key Stats
98%
of Medicaid population covered by our partnering CCOs
1000s
of accountable in-network programs
62%
of Medicaid population supported with social care payments by our contracted CCOs
Chosen
CCO and State Agency HRSN Technology Partner
New York
Unite Us has the largest accountable social care network in New York State with trusted partners in all 62 counties. Unite Us will partner with Social Care Networks to power HRSN reimbursements for New York’s 1115 waiver demonstration.
Key Stats
All 62
counties contain trusted partners
#1
largest accountable social care network
California
Unite Us has built a responsive and accountable social care network across California enabling real-time collaboration, coordination, and reimbursement to support the DHCS requirement for closed-loop referrals.
Key Stats
40 Counties
with active programs supporting government-funded benefits and other care
Powering
the Veterans Peer Access Network in LA County serving the country’s largest veterans population
State Data Last Updated: May 2024
