Disease Management
Member Empowerment
Powerful, Workable Solutions. As healthcare costs rise, employers continue to seek powerful, workable solutions to reverse the trend. 80% of all U.S. healthcare expenditures result from chronic conditions that can be managed with viable alternatives. Primary PhysicianCare understands the importance of Disease Management programs that promote optimal health and productivity.
Improving the Bottom Line
Experience. With more than 30 years of experience in meeting the needs of employers, Primary PhysicianCare has the tools and experience to help you:
- Improve the health and well being of your employees
- Lower healthcare costs and deliver an ROI that supports your decision making
- Decrease absenteeism and presenteeism
- Lower costs associated with lost employee productivity
- Maintain a competitive edge by offering benefits that help you attract and retain employees
Disease Management in Action
Quality of Life . Trust our proven phases of disease management to improve the quality of life for your employees:
1. Identification. Using our proprietary predictive modeling software, we analyze claims data, prescription drug data, health risk assessment data, and lab data to identify members who are at risk for chronic diseases. We then stratify members according to their risk levels into primary chronic disease categories allowing us to target the higher-risk members first.
2. Intervention. Patients with one or more identified conditions are entered into our DM medical records software called the Care Management System. This system enables our nurses to manage their assigned member populations; view all available claims and encounter data in real time; and schedule needed follow-up calls, doctor visits, and lab work. It also is used to measure and document a member’s compliance with disease protocols. After the appropriate time period (typically after one year), reports are produced that illustrate the aggregate activity and outcomes for the group.
3. Activity & Outcomes Reporting.
Our software system allows for detailed clinical measurements, which include lab values, follow-up visits, necessary tests and screenings, patient’s education level, medication compliance and more. This data allows us to measure clinical outcomes at the member level and at the group or population level. We also measure and report utilization outcomes such as hospital stays, ER visits and average length of stay. Lastly, we can measure financial outcomes of the population group against our book of business and against national normative data.
