Sustainably Lowering The Total Cost of Care

Benefits

While care coordination benefits and models can differ, the core of any approach is the same: to identify patients who require more coordinated care and facilitate the delivery of appropriate care, at the right time, in the proper place.

Care Coordination aims to ensure provider and patient satisfaction through delivery of appropriate healthcare services at the right time in the proper setting. Our team of dedicated care coordinators work with patients and providers to encourage adherence to the medical plan and support transitions effectively. Through advanced analytics and comprehensive understanding of the benefit plan, the care coordination team can bring value in referral management, pharmacy management, and reducing the total cost of care.

The Status Quo

The healthcare system is a complex and costly network of independent entities:

  • providers,
  • insurers,
  • government organizations,
  • physicians,
  • specialists,
  • payers,
  • and regulators.

It's extremely difficult for patients and their providers to determine the effect of any single treatment, or to assess their overall quality of care. 

Time has taught the industry that patients with critical or chronic medical issues need significant help navigating our complex medical delivery system.

Without navigation services, these members are likely to utilize unnecessary services or treatments, both in- and out of network. 

 


 

Long-term, sustainable savings 

Regardless of the initial discount , true cost-saving innovation:

 

Built on a network of vetted providers.

Medical providers in a broad network lacking embedded care coordination find it more difficult to coordinate member care.

 

Design with care coordination embedded.

Lack of coordination is often why large networks fail to incentivize cost-reducing and quality-enhancing activites. When care coordination is merely a "bolt on" the critical sharing of data for prediction (reduces the total cost of care, year over year) and member care (improved health outcomes) is throttled. 

 

Incentivizing and empowering providers to focus on long-term health outcomes.

Providers in a broad network typically operate within the traditional, fee-for-service model, which financially incentivizes volume of services--necessary or otherwise. 

Our broad network solution embeds the care coordination and data transparency required to empower vetted providers, incentivized to practice medicine with members long-term health outcomes in mind.

 


 

The Healthcare Highways Advantage 

Care Coordination improves communication between specialists and primary care physicians to maximize treatment plan effectiveness. Healthcare Highways’ model of coordinated care incorporates:

 

1. Deeply engaging providers who believe in collaborative care.

Healthcare Highways partners with providers who have demonstrated track records of efficient care protocols and improved health outcomes. These physicians are continuously monitored to meet standards of quality care, sharing in our commitment to lowering costs, increasing efficiency, and improving patient lives.

 

2. Empower effective care management through acquiring and sharing data insights.

Through ongoing data collection and analysis, Healthcare Highways ensures its providers receive continuous insights as their patients’ progress through their care journey. Easy access to meaningful data aids providers in proactively managing a patient’s ongoing healthcare needs.

 

3. Creating incentives for quality, efficiency, and patient experience.

Providers are financially rewarded for efficiently improving patient health outcomes through increased primary care engagement and monitoring. Healthcare Highways created marked member engagement and health outcome improvement using its care coordination model in Oklahoma over the course of just one year:

  • Hospital re-admissions dropped from 11.71 percent to 9.84 percent

  • Breast cancer screening rates increased from 63.81 percent to 72.04 percent

  • Colo-rectal screening rates increased from 30.53 percent to 41.56 percent

Employers intent on providing their employees a more effective suite of healthcare solutions should consider care coordination a prerequisite component of their health plan strategy.

Not only will employees enjoy a higher quality of care, but the entire organization will reap economic benefits in the form of better data insights, a healthier workforce, and lower total cost of care.

 


Want more information? Instantly download our free e-guide below:

Link to download our embedded care coordination guide