Our Commitment To Health Homes, Dual Eligibles, ACOs & Care Coordination Organizations, Or More Generally: Population Health

By embracing coordinated, person-centered care, we have the opportunity to improve outcomes while reducing costs. Together, as we focus on the needs of the person receiving care in different settings -- including physical, behavioral and social care -- we have the ability to:

  • Reduce emergency department admissions
  • Reduce hospital re-admissions
  • Manage transitions of care

We share the same mission:

Identify those patients with multiple chronic diseases or those who account for a disproportionate amount of your cost, and coordinate their care to ensure they get treatment in the lowest acuity setting possible while managing the rest of the population to ensure they stay on the path towards better health. The key to this mission is identifying those who could become at-risk and addressing their needs before they become acute.

Health homes, Accountable Care Organizations (ACOs), dual eligibles and care coordination organizations across the United States use our care management software system to perform the tasks described above. Whether your goal is to integrate with one of our EHR solutions or EHRs from other vendors, we have the health information exchange and portal solutions, claims management, and revenue cycle or claims cycle management services technology to support a fully integrated system of care.

Whether you’re a health home providing care management to improve the quality of care and decrease costs, an ACO managing low and high-risk individuals, dual eligibles, or a care coordination organization working to effectively manage members with multiple chronic conditions or those who represent the highest cost to your engagement strategy, our solutions will help you not only survive, but thrive in the integrated healthcare system of the future.

Our objectives for our partnership with health homes, ACOs, dual eligibles, and care coordination organizations are pretty simple:

  • Integration:

    Connecting you to other care providers…allowing you to share information anytime
  • Visibility:

    Providing you visibility into the total health of an individual, as well as where they receive care
  • Analytics and Knowledge-Driven Care Management:

    • Identification:

      Who are the individuals to manage
    • Segmentation:

      Meaningful groupings of the at-risk individuals aligned to programs or services
    • Stratification:

      Profiling and ranking of the at-risk individuals to guide prioritization of interventions
    • Intervention:

      Actions that alter the trajectory towards desired outcomes
    • Monitor:

      Measure to ensure desired outcomes and/or identify opportunities for continuous improvement

Most importantly, our relationship with you is bigger than a transaction, more than a support-only relationship. It’s about a common alignment to serve the addiction treatment and prevention community.

For more information on how we are uniquely positioned to partner with your organization in the era of an ever-changing healthcare ecosystem, please contact us.