Care Coordination Advantages
The key to lowering healthcare benefit costs lies in improving long-term health management for high-risk populations — those with co-morbid chronic, complex medical concerns, like diabetes — through care coordination.
A well-defined care coordination program reduces costs by addressing employee health concerns before they incur significant medical expenses.
A Healthier, More Productive Workforce
With centralized oversight:
- gaps in patient records are eliminated and
- efficient access to appropriate care.
Healthy employees are more productive, less likely to use sick days, and maximize the benefits of their health plan.
What is Care Coordination?
Care coordination leverages a dedicated group of healthcare providers (RNs, care managers, pharmacists, dietitians, etc.) who work with the patient and primary care physician to ensure the patient has the appropriate resources and continual guidance to adhere to their health management plan. Ultimately, care coordination helps ensure the delivery of appropriate healthcare services at the appropriate time and in the proper environment.
Improved Cost Savings
By identifying high-risk patient populations before they incur costly medical intervention and reducing their likelihood of requiring more complicated care, employers can reduce total medical expenses over time, which leads to stable premiums.
When provided health data in near real-time, employers can clarify the ROI of their health benefit plan and make cost-saving predictions. It's your data--you should always have access and reporting assistance embedded in your plan.
Care coordination yields improved health outcomes and patient experiences.
Improved Education and Understanding
Employees who understand they have a care coordination program available to them are typically more satisfied with their benefits program. Patient advocates can intervene:
- to prevent unnecessary or redundant treatments (and their associated costs),
- find cost-effective treatment options,
- assist with claim resolutions, and
- explain plan benefits.
Better Health Outcomes
There are six areas of focus that may be introduced to the member depending upon their own unique health profile and preferred level of engagement:
- Care decision support
- Quality and prevention
- Chronic disease support
- Complex care support
- Medication support
- Transition of care
Continuous communication with care coordinators improves medication and treatment adherence leading to better clinical outcomes.
Care coordination facilitates continuous communication between the patient and primary care physician, ensuring access to critical information that leads to improved health outcomes long-term.
Extended Care Team Visits
The primary care physician benefits from:
- an extension of a PCP's office-based care team
- additional monitoring of their patients in-between office visits
- reports of clinical improvements, admissions, and ER visits
Care coordination models report critical information:
- patients’ treatment histories,
- medication adherence,
- new symptoms, and
- chronic condition maintenance.
With more data, providers can make more informed decisions about their patients’ paths to treatment.
Improved Patient Outcomes
Providers who take advantage of care coordination models typically see clinical outcomes improve for the patients they serve. Ancillary benefits of these models include:
- care team motivation,
- financial rewards based on positive patient outcomes,
- practicing at the top of a providers’ license, and
- from from over-reliance on Fee For S payment