Healthcare Solutions
Improving Outcomes for Complex Populations
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Behavioral Health
- Integrated case management
- Evidence-based utilization management
- Customized care pathways
- Digital care delivery
- Real-time BH screening and data mining
- Expert care for long-term services and supports (LTSS), autism, serious mental illness (SMI), substance use disorders
Specialty Medical Solutions
RADIOLOGY
- Evidence-based algorithms
- Clinical validation of records
- Physician review for approvals and denials
- Peer consultation
- Free-standing facility network
MUSCULOSKELETAL/CHRONIC PAIN
- Interventional pain management and surgery benefits management
- Clinical validation of records
- Promotion of patient safety
PHYSICAL MEDICINE
- Proprietary provider profiling and tiering to reduce variation and costs
- Specialty-matched peer-to-peer consulting and CVR
- Dynamic and targeted re-service reviews at patient and provider levels
CARDIAC
- Evidence-based guidelines and proprietary algorithms for care alternatives
- Peer-to-peer consulting by board-certified cardiologists
- Customized based on client/market needs
Employee Assistance Programs
- Health, wellness, legal, financial, workplace, critical incident stress management and work-life services
- First-to-market digital platform for services, identification, intervention and care
Full-Service Managed Care Plans
- Medicaid
- CHIP
- Medicare
- Medicare-Medicaid integration
- Long-term services and supports
Complex Populations
- Chronic pain
- Musculoskeletal issues
- Serious mental illness
- Suicide programs
- Substance abuse