Care Management business overview: The Unified Model of Care
Healthcare organizations are turning to care management to support member or patient engagement for various programs, from wellness to management of chronic conditions.
Integrated care management strategies connect care navigation, case, disease, and utilization management programs to improve the communication and collaboration of all the stakeholders in the care equation. Navigating the care of the patient or member is important so that patients can locate and access the right treatments, generally understand their illnesses, and fully comprehend their care plans. Successful healthcare navigation addresses patients' financial needs and alleviates their emotional, spiritual, familial, and physical struggles.
Care Management, the "Unified Model of Care"
One way to accomplish these business objectives is by taking a holistic, patient-centric view, and cohesively managing the entire spectrum of health services across the continuum of care. This unified model of patient care can enable our healthcare organizations to provide a proactive to preemptive approach, versus a reactive, unplanned approach to high-cost situations, which are representative of most healthcare costs. Providing a preemptive approach improves trust and loyalty to the healthcare organization by anticipating needs and events for the patient before they become service-level events.
Improving the overall quality of care in a covered population and avoiding costly, adverse events, such as hospitalizations and exacerbation of the disease, results in a positive "win-win-win" situation for the patient, the provider, and the health plan.
A comprehensive care management approach includes enabling care teams to develop and implement innovative care management programs across a range of case, disease, utilization and wellness management situations. These advanced care management programs require unique technologies with capabilities that improve communication and collaboration among physicians, healthcare organizations, patients and other stakeholders in the care equation.
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