Let’s Grow Your Agency Together

Better margins, smarter care, and less hassle

Ruby will optimize your PDGM + HHVBP performance and bring your agency into a new era of success and profitability with MA plans.

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What Ruby Brings to your Agency

Better Economics with Medicare and Medicare Advantage
  • Better value-based contracts with MA plans and ACOs.
  • Lower staffing burden and less paperwork.
  • Faster, simpler payment process.
  • Freed up capacity to allow you to take on more patients.
Clinical Backup, On Your Terms
  • Ruby physicians, nurses, and care managers  keeps tabs on your patients in between your agency’s home visits.
  • Supports agency clinicians when and where they need it: urgent care access, med adjustments, and care plan consultations.
Tech That Works for You
  • Ruby can read and write into your EMR for seamless communications.
  • Real-time data and team alerts.
  • Using industry leading AI support tools, Ruby will help target patients with needed interventions and increase efficiency of care teams.
What Ruby Delivers
3X
Increase in margins across traditional Medicare and MA episodes
25%
Reduction in preventable hospitalizations
30%
Increase in nursing staff capacity
Ruby Programs
Ruby can partner with your agency for both Medicare and Medicare Advantage populations.
Traditional Medicare
⁠Ruby optimizes your  PDGM + HHVBP performance and creates VBC relationships with ACOs and hospitals
Medicare Advantage
⁠⁠Ruby negotiates VBC contacts with MA Plans that you can choose to enter and helps you perform
With a Traditional Agency
An elderly patient with multiple chronic conditions is discharged from the hospital.
Traditional home health provides 10-12 in-person visits over several weeks, with limited coordination and higher hospitalization risk.
With Ruby
We streamline the journey.
6–8 in-person HHA visits
and 15-20 remote Ruby interventions:
medication management, social work, care management, escalation handling, and real-time PCP coordination.
Ongoing virtual support and education keeps the patient stable and out of the hospital.
Explore the full care timeline
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Meet Thelma, 82
Living with CHF, CKD IV, obesity, and chronic angina. She was hospitalized with sepsis from pneumonia and discharged six days later with a home health order.
Referral received by HHA.
Ruby team notified. HIE data pulled.
- 1
Day
Patient discharged but not yet at baseline.
Still weak and SoB.
Day
0
Patient seen by HHA RN, OASIS completed,Ruby extender team introduced
Ruby care manager (CM) follows up within 24 hours. Receives HH OASIS data.
Day
1-2
IDT meeting with HHA, risk strat and care plan completed
Day
3
HHA submits PT referral and DME request for walker.
High risk patient - daily phone calls, SW referral, MD review, medication reconciliation; PCP visit; DME arranged
Day
3-10
No HHA activity
Ruby Provider optimizes medications - new hospital meds stopped; home dose CHF/CAD meds restarted
Day
4
HH RN urgent visit verifying worsening CHF
CM notices increased SoB, requests HH RN visit, provider escalation, dose adjustment furosemide x 3 days; PCP notified
Day
6
PT works with patient and new walker
Symptoms stabilize, patient/ caregiver educated on action plan and new med dose.
Day
7-10
Final PT and RN visit
CM verifies PCP visit completion,
SW makes CBO referral, ongoing education
Day
14
No HHA activity
Weekly CM calls focused on med adherence and patient activation; SW closes SDOH gap; cardiologist F/U
Week
3-9
No HHA activity
Patient transitioned to PCP; Ruby documentation synced to HIE
Week
10

What It Looks Like for Your Patients

️Near daily contact for high-risk patients
We make it easier for Home Health teams to deliver high quality care to more people, with less friction
Medication adjustments, education, and social support
Smooth transitions back to PCPs and specialists
25% fewer readmissions

Ruby Augments Agencies

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A Digital Medical Group + Care Management
Ruby uses AI enhanced care planning to guide our interdisciplinary team as we together work to reduce hospitalizations.
AI Enhanced Clinical Tools
From risk stratification, to wound care, to deprescribing, Ruby uses best in class partners to improve care.
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Value Based Care Enablement
With population health analytics, HEDIS gap closure, risk score capture and readmission reduction expertise, Ruby will help you succeed in value based care.