Are you getting value from care management?
With the top 5% of plan members eating up about half of the dollars spent by the typical benefits plan, most employers offer case management and disease management services, usually through their third-party administrator or another vendor. Many, though, are unsure whether these services are having their intended effect and are dissatisfied with their ability to hold vendors accountable.
An expert appraisal of disease and case management services
Through Employee Health Compass, we evaluate the quality of service provided by each member’s vendors and customize a plan for enhancing results. Grounded in best practice research, our advice varies greatly depending upon the employer’s needs and the vendor’s performance.
Focus on enrollees to find risk, prioritize patient segments
For some employers, we focus on who enrolls in care and disease management programs. Using advanced clinical algorithms, we spot patients with significant health risks who are not complying with recommended care protocols. We analyze diagnoses, medical and drug utilization, and biometrics (when available) to flag high-risk individuals and prioritize patient segments.
For some collaborative members, learning that their greatest threat comes from one particular illness is the key to better results. For others, it is receiving a monthly list of high-risk candidates to share with their vendor. And, sometimes, it is our efforts to partner with their vendor to ensure their outreach methods yield high enrollment.
Measure a vendor’s impact—or bring your programs in-house
Our experts also focus on what happens after enrollment, with a special emphasis on tracking outcomes to measure the return on investment—financial and otherwise—for vendors’ services.
When applicable, we support collaborative members—primarily hospitals and universities—who want to bring case management and disease management services in-house. We advise directly and connect members with others in the cohort who have pursued or considered a similar strategy.
See how we helped one member optimize its disease management contract
Request more information on Employee Health Compass
