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Connecting your members to the right care
Our comprehensive and integrated approach to care management is grounded in our strong local presence and relationships, enabling us to provide your employees with personalized support that connects them to the right care and resources. This leads to better outcomes; promotes more informed, empowered decision-making for your employees; and reduces costs through early and targeted intervention and guidance.
We accomplish this in four ways:
Managing chronic and complex conditions
• Monitoring employee health trends and patterns to ensure they receive appropriate health care
• Supporting providers in care planning and interventions with robust data and analytics
• Giving employees support and tools to better manage, organize,
and engage in their care
Supporting mental and behavioral health
• Facilitating collaboration between primary and behavioral health care providers through programs like Quartet
• Increasing access to virtual telebehavioral health care,
online programs, and digital tools
• Focusing on effective substance use treatment and recovery
• Expanding public awareness with campaigns like #KnowYourMind and #MindPHL
Utilization management by the numbers
Managing utilization effectively
• Working directly with providers
to monitor medical necessity and coordinate appropriate health care
• Partnering with expert vendors to address complex and costly medical treatments
Increasing engagement through health coaching
• Layering analytics on top of data to identify risk, then conduct outreach to engage and educate members
• Identifying current and future health risks through targeted clinical messages and outreach
• Providing 24/7 access to a Registered Nurse Health Coach, resources, and support for members with chronic conditions
• Offering a maternity program that supports pregnant members
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