A large integrated delivery system with both a health plan and physician group component. The Challenge
1) Develop an effective and consistent approach for identifying and
stratifying members for the client’s on-site and telephonic care
2) Identify high-risk populations who were not eligible for enrollment
in existing programs and assist with developing programs for these
A custom analytics program delivered:
- A uniform approach to identifying members for all existing onsite and telephonic programs.
- Identification and stratification of members eligible for these programs
of members who were not receiving onsite outreach followed by
collaboration with the client’s clinical leadership to develop criteria
for new programs.
Health Dialog then trained the in-house care management staff in Shared
Decision Making and other Health Dialog coaching techniques to ensure
consistency of care support services. The Results
Aligned client’s care management resources; streamlined member
identification and eliminated duplication of work; created an
integrated care management approach for members at high financial risk.