Complex Care Management

Complex Care Management

Coordinated Care for High-Cost Member Populations

For improved clinical and financial outcomes, health plans need to coordinate programs for chronically ill, high-cost populations. They must also effectively manage utilization and deploy resources where they do the most good.

With Aerial Complex Care Management, health plans can build automated member-centered care management workflows to better coordinate care and refer members to appropriate services. Automated care workflows drive down costs and improve overall coordination of members’ treatment plans—ever important in today’s value-based care environment.

 

Put proven, evidence-based care management to work for your organization

Aerial Complex Care Management is a rules-based, automated workflow app with NCQA-certified clinical content that guides the most appropriate member interventions and care plans. Aerial™ Complex Care Management includes:

  • Case Management
    • Efficiently build and execute evidence-based programs for high-cost populations
    • Create member-centered care plans, identify the most appropriate intervention levels and give the entire care team access to disease-specific best practices
  • Disease Management
    • Target more than 30 disease states with NCQA-compliant and NCQA vendor DM-certified disease management solutions
    • Conduct well-informed screening assessments
    • Help members learn effective ways to manage their illnesses, while personalizing interventions to address NCQA and HEDIS® requirements
  • Utilization Management
    • Gain better visibility into the most appropriate care and network utilization with built-in workflows
    • Automatically validate medical necessity and treatment appropriateness, plus gain workflow paths for authorizations and exceptions

Find valuable care coordination opportunities. Use care management solutions to better control clinical and financial risk while improving care quality for members.

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