Manage the Cost of Care

Manage the cost of care

Manage Care Costs, Manage Risk

Complex, high-risk populations are growing, and so is commercial and government healthcare spend. That’s why health plans managing these populations need innovative ways to reduce costs without sacrificing care quality. By using predictive models to provide timely, effective care and cost management, plans can optimize both care quality and revenue under traditional, value-based and other emerging reimbursement models.

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Identify high-risk members, build engagement to reduce costs

Care management programs that use predictive analytics and engagement strategies to align members with their care teams have fewer unnecessary utilizations and more effective network usage. That can lead to cost containment with better clinical outcomes.

This is especially important for health plans managing high-risk and high-cost members. But to get there, health plans need:

  • Population-level analytics and data to identify high-risk and rising-risk members sooner to drive more effective interventions
  • Care management programs that improve care coordination workflows, ensuring quality standards are met to help prevent avoidable hospitalizations and
 readmissions
  • Automated care workflows with clinical programs tailored to the chronic, cognitive and functional needs unique to government beneficiaries
  • Care management and utilization tools that enable better revenue recognition and cost management
  • Collaboration platforms and programs that educate, engage and drive members to follow their care plans, use high-cost services properly and make meaningful behavior modifications

Medecision gives health plans the tools and insights needed to drive higher quality care at a lower cost and facilitate collaboration, by spotting—and destroying—hazards on the road to managing clinical and financial risk.

That leads to better quality outcomes and lower costs for everyone.

MEDECISION’S ADVISORY SERVICES TEAM OFFERS EXPLORATORY ASSESSMENTS TO HELP YOU IDENTIFY OPTIONS AND STRATEGIES TO ACHIEVE CLINICAL AND FINANCIAL SUCCESS.

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