Care Management identifies and manages the real driver behind the rising cost of healthcare – the two percent of the population that generates 40 percent of the cost. Our URAC-accredited care management team, in conjunction with our registered nurses, provides better care and after-care follow-up to reduce risk and help reduce the episode of care costs.
Care Management Benefits
- Interfaces with reinsurance vendors
- Coordinates specialty pharmacy program needs for patients
- Reduces episode of care costs
Care Management Features
- Assesses patient’s needs and then plans, coordinates and monitors services to ensure smooth, effective care and recovery
- Manages activities with providers and care programs, including second opinions and transplant networks
- Keeps communication channels open between patient (and family) and doctor, employer, insurance companies and benefits managers
Condition (Disease) Management
By coordinating health and benefit management, our URAC-accredited team promotes early intervention and can decrease the long-term cost of disease care. Health analytics can even provide predictive modeling for individuals with chronic or mid-term health conditions.
Disease Management Benefits
- Decreases the long-term cost of diseases
- Promotes early intervention, self-management and compliance with treatment plans
- Provides education, support and referrals
Disease Management Features
- Registered nurses and physicians review the medical and pharmacy claims of those who may benefit from Condition Management. Modules include:
- Chronic obstructive pulmonary disease
- Congestive heart failure
- Coronary artery disease
- Degenerative joint disease
- Gastric reflux
- Low back pain
Four percent of the average payroll can be attributed to unscheduled absences.
Our registered nurses help manage unscheduled absences, patterned short-term illness, short-term disability, long-term disability and workers compensation to maximize your company’s productivity and profitability.
Absence Management Benefits
- Promotes early intervention and management of health and disability claims and trends
- Improves productivity
- Coordinates and outsources services for difficult cases
- Provides the clinical expertise to understand absence issues
Absence Management Features
- Proactive assessment, benchmarking and management of employees’ unscheduled work absences
- Includes short-term disability, long-term disability, FMLA and workers compensation incidences and claims