Comprehensive Case, Disease and Utilization Management in a Single, Fully Integrated Platform

The ability for care managers to coordinate the best care for their patients is reliant on them having visibility into data that provides actionable insights. Our CareConnect™ solution can ingest batch data from any source and provide one overarching view of patient care. This facilitates case management and disease management, including potentially avoiding hospital readmissions, the ability to choose appropriate care settings, and engaging with the patient to better manage their own health conditions. All of these factors can contribute in reducing utilization costs for the plan and optimizing care for the member.

  • Real-time integration with our claims system means the care team always has current member information.
  • Cases and care plans are automatically created using risk stratified population data from any source. We recommend CareAnalyzer®, which utilizes Johns Hopkins Adjusted Clinical Groups® (ACGs).
  • Client-defined care plans are embedded in the workflow, which can be personalized to monitor and close existing care gaps.
  • Utilization Management workflow is automated to support turnaround time compliance.
  • Discharge planning tools assist with transitional assessment, care planning, and medication reconciliation to reduce readmissions and support member self- management.