Chronic Condition Management
The vast majority of claims costs in any population are driven by a limited number of individuals dealing with specific chronic health conditions
Methodology - Develop incented clinical access models for at-risk demographic and condition cohorts combined with patient outreach which targets critical population health concerns in a value based reimbursement model.
- Patient home outreach provides an opportunity for preventive care and chronic condition improvement
- Greater opportunity for value based models, leading to enhanced population health metrics
- Expanded monitoring of key metrics for specified conditions
"At Risk - 15" Strategy
Voluntary wellness arrangements typically focus on health education and support services. These arrangements are valuable mechanisms for increasing general health literacy. However, most traditional voluntary Wellness Programs fail to utilize enhanced identification and intervention strategies for intervening with the limited number of individuals who are most at risk and represent the majority of health costs.
"At Risk - 15" focuses on a subset of employees (often 15% or less of all employees) who are the most health vulnerable, where even small health improvements can have substantial cost benefits.
The Private Benefit Network Chronic Condition Intervention Program is a focused intervention strategy designed to support at-risk individuals within insured populations, combining focused condition metrics, patient home outreach, expanded condition education and enhanced RX adherence to provide better medical outcomes. This is coupled with direct cost reductions on associated RX and supplies, allowing self-insured health plans, MEWAs and Association Health Plans to achieve immediate cost savings, as well as long term claims improvements.
- Directed Patient Engagement
- Encrypted, Bluetooth enabled, Metric Management
- Patient Home Outreach
Target Population
- Public sector health plans
- Employer self-insured plans, MEWAs, Association Health Plans
- Individual insureds
- Direct placement/Exchange
- Medicare populations
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