Payer Infrastructure for Dual-Eligible Populations

Activate needs-based benefits. Sequence the funding source. Document what actually happened.

Anchor orchestrates non-medical benefits for dual-eligible members within existing care management workflows. Care managers activate needs-based benefits in fewer steps, plans match each need to the funding source responsible for it and can prove what was delivered, and members receive the services matched to their needs.

Anchor recommends; the care manager decides. Anchor does not author criteria, determine eligibility, or enforce caps.

Non-medical benefit orchestration for Medicare Advantage plans serving dual-eligible members

Non-Medical Benefit Orchestration

Triggers & Inputs
Care management platforms
Plan benefit criteria and PBP
HRA data
Care manager and provider touchpoints
Enrollment and eligibility files
→
Anchor
Surface
Benefits to consider, matched against the plan’s criteria
Sequence
Which funding source covers the need first
Route and Confirm
Referrals documented; each vendor’s record accepted and graded
Document
Criteria and PBP on record, attributed to the member
→
Service Delivery (existing ecosystem)
Transportation
Food and nutrition
Home modifications
In-home supports
Caregiver / loneliness
The plan’s contracted vendors and community programs
Anchor recommends; the care manager decides
Preferred Vendor
A dual-eligible member’s needs are met through SSBCI and the plan’s other supplemental benefits, Medicaid, waivers, and community programs. Care managers refer to each one through a separate process.

Each funding source works with its own vendors, data formats, and reporting cadence. Caseloads run in the hundreds, and the next call may reach a different care manager, with no single record of what was referred or where it stands.

Anchor orchestrates non-medical benefits for dual-eligible members. Care managers work from one screen, and every service is substantiated at the member level.

How Anchor Works

From a Member’s Need to a Documented Service

Anchor works within existing care management workflows. No care-management platform integration required to begin.

Surface

Anchor matches the member against the plan's criteria and surfaces the benefits to consider. The plan determines eligibility. For SSBCI, the qualification is recorded with the benefit criteria and the PBP that applied.

Route and Confirm

Referrals to contracted vendors and community programs, with the latest available cap balance at referral. Anchor documents every referral, and each vendor's record is accepted and graded.

Document

Member-level data captured at the point of decision: benefit criteria, PBP, evidence, who decided, and when. Producible for any member, any date.

Anchor recommends; the care manager decides. Anchor does not author criteria, determine eligibility, or enforce caps.

What the Plan Gains

Three Outcomes for the Plan

Care management, finance, and quality read the same member-level record of needs, referrals, and services.

Improve efficiency

Care managers send referrals and confirm services from one screen, replacing manual steps.

Simplify member experience

Members receive needs-based services. The status of every referral sits in one record the plan can read when the member calls.

Across the Plan

One Record, Seven Teams That Use It

The spend happens either way. Anchor makes it activated, matched to delivery, and attributable, from one record.

Care management

One screen from need to confirmed service. Fewer steps per activation.

Member services

Where a referral or an open request stands, on the first call.

Vendor management

Referrals sent, fulfilled, and time to delivery, by vendor.

Quality

Benefits activated and days to confirmation as member-level inputs.

Compliance and audit

Member-level determinations, with criteria and PBP on record, attributed, producible for any member, any date.

Finance and med econ

Authorization matched to delivery. The documented event behind each funded service.

Product and bid

Cap use, time to activation, and vendor delivery as observations.

One record the whole plan can act on.Access is role-based. The plan defines what each role sees.
Outcomes We Document

Measured at the Member Level

Anchor documents four outcomes at the member level as the work happens, within the plan’s existing care management workflow.

Benefits activated

Needs-based benefits referred for each member.

Days to confirmation

Time from referral to a confirmed service, per referral.

Care manager time per case

Time spent on referrals and follow-up, per member.

Sample member record

See what the record looks like for one member

We’ll build a sample member record for one of your states and a benefit class: the criteria and PBP on record, the funding source that covers each need first, each referral, and each vendor’s record. Our team walks you through what it contains.

Request a sample →

See How Anchor Works
in Your Plan

Anchor orchestrates non-medical benefits for dual-eligible members. Every service is substantiated at the member level.

Request a Demo

Privacy Policy

Last updated: April 2026

Introduction

Anchor Care, Inc. ("Anchor", "we", "us", or "our") operates the Anchor website and platform (collectively, the "Service"). This page informs you of our policies regarding the collection, use, and disclosure of personal data when you use our Service.

Information Collection and Use

We collect information for various purposes to provide and improve our Service, including data you provide to us (such as contact information), data collected automatically (such as usage patterns), and data from third parties (such as analytics providers).

Data Security

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Trust Center

Last updated: April 2026

Security & Compliance

Anchor is committed to maintaining the highest standards of security and compliance. We implement multiple layers of protection to ensure your data is safe, including encryption, access controls, and regular security audits.

Data Handling

All data is handled in accordance with HIPAA, state and federal privacy laws, and industry best practices. We maintain strict policies around data access, retention, and deletion.

Certifications & Standards

SOC 2 Type I targeted Q2 2026. SOC 2 Type II targeted Q4 2026. HITRUST r2 certification is on our 2027 roadmap. Anchor operates under HIPAA-compliant data handling practices with encryption in transit and at rest, role-based access controls, and annual third-party security review.

Contact Security Team

For questions about security, compliance, or data handling, please contact our Trust & Security team at security@anchorcare.ai.