MEDICAL MANAGEMENT
Driving Successful Managed and Value Based Care Independent Physicians Associations
Utilization Management
IPAs must appropriately utilize services necessary for their members. Over utilization can drive up costs unnecessarily, while under utilization can have the same effect. Primary care physicians and all healthcare facilities traditionally have siloed practices but with the insight into claims and other important clinical information, the user is able to gain insights into how other services are being accessed outside of their facility perimeters. Control utilization: analyzing metrics per 1000 as well as the relative change compared to prior performance is how the IPA can move towards utilization goals.
Quality Management
Completion of IPA quality metrics is an established CMS requirement in order to benefit from shared savings. Manage quality; metric reporting is completed at the beginning of the next performance year and is a reflection of compliance of the prior year. It is important for the IPA to understand how they are performing on each individual metric to ensure a high compliance rate by the end of the year.
We assist you to identify:
- Physician customized patient care priorities
- Members missing required preventative procedures
- New assigned members that need AWV
- Which intervention strategies appropriate
Care and Case Management
We provide and coordinate care management where they can have the greatest impact. Powered by advanced analytics predictive technology, we identify which patients are most likely to experience serious and preventable medical episodes. Our dedicated care advisors draw on their clinical backgrounds and our proven methodologies to optimize patient outcomes.
Member Health Education
- Age Specific Guidance
- Asthma
- Breastfeeding
- Dental
- Diabetes
- Hypertension
- Immunizations Injury Prevention
- Poison Prevention
- Nutrition
- Obesity
- Parenting
- Perinatal
- Substance Abuse