Member Utilization Management Solutions
Understand in real time when your members are seeking treatment to optimize for quality and cost
Hospital readmissions and unnecessary ED visits can be disastrous for the patient. They also can be detrimental to provider quality scores and cause penalties against value-based reimbursements for health plans and providers.
With the adoption of value-based care models, reducing readmission rates and ED utilization has become one of the biggest challenges healthcare organizations now face.
Both advanced IT strategies and progressive patient engagement strategies support proactive and real-time interventions that have a positive impact of readmission rates and unnecessary ED visits.
Enables risk-bearing organizations such as ACOs, ESCOs, and health plans to actively manage members’ high-cost clinical episodes through real-time, configurable ADT notifications to optimize care settings and transitions.
Power your patient engagement strategy with a holistic view of patients, including non-medical attributes, and engage with your patients and members in meaningful ways that help prevent no-shows, encourage healthy habits and support positive health outcomes.