The Client
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 management programs.
2) Identify high-risk populations who were not eligible for enrollment in existing programs and assist with developing programs for these members.

The Solution
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
• Identification 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.