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Care Coordination Management

Case Management identifies and manages the real driver behind the rising cost of health care - the two percent of the population that generates 40 percent of the cost. Our case management team, in conjunction with our registered nurses, provides better care coordination and after-care follow-up to reduce risk and help reduce the episode of care costs.

Care Coordination: Case Management

Case Management identifies and manages the real driver behind the rising cost of health care - the two percent of the population that generates 40 percent of the cost. Our case management team, in conjunction with our registered nurses, provides better care coordination and after-care follow-up to reduce risk and help reduce the episode of care costs.

Case Management Benefits

  • Interfaces with reinsurance vendors
  • Coordinates specialty pharmacy program needs for patients
  • Reduces episode of care costs

Case 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

Care Coordination: Condition (Disease) Management

By coordinating health and benefit management, our registered nurses promote early intervention and can decrease the long-term cost of disease care. Informed 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:
    • Asthma
    • Chronic obstructive pulmonary disease
    • Congestive heart failure
    • Coronary artery disease
    • Degenerative joint disease
    • Diabetes
    • Gastric reflux
    • Hypertension
    • Low back pain
    • Obesity
    • Pregnancy

Care Coordination: Absence Management

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

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