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