Page 10 - Amerihealth New Jersey - 59-99 - 2021 Benefits at a Glance
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Optimizing the value of health care
As stewards of your dollar, we regularly review our programs, processes, and policies. We use industry benchmarks and best practice standards to identify and address outliers in health care costs and utilization. Once we identify opportunities for improvement, we embed them into our utilization management and claim payment policies.
Driving value in medical management
We have optimized our medical management savings to ensure members receive high-quality health care in the safest setting. As a result, we are:
• Driving evidence-based care
• Reducing the number of unnecessary procedures and related costs from
potential complications
• Increasing member access to services in the most cost-effective setting
Health Care Value Optimization
Network Management and Reimbursement Administration
Utilization Management
Payment Optimization Medical/Pharmacy Policy
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