Are Payer-led medical cost management programs proliferating?
However, the reality is that many providers are not yet fully equipped to deploy a successful suite of population health management capabilities, and even those that are face years of steady work to bend the cost trend.
Consequently, payer-led medical cost management programs are proliferating.
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Clinical Strategy and Care Management to Empower More Informed Decisions
According to UnitedHealthcare research, employees made less-than-optimal health care choices 38% of the time, which directly impacted their health — and increased the cost of health care for everyone.18 And with more than half of all adults having 1 or more chronic conditions,19clinical management strategies play a key role in containing costs.
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Plans and Networks Designed For Better Care, Greater Value
Primary care providers have the ability to impact $0.61 of every health care dollar.9Understanding their role, UnitedHealthcare network strategies focus on providers and systems that deliver proven quality and efficiency.
The approach also aligns with employers seeking innovation in network and plan design as a key strategy to control costs.10 This.
Human Resource Specialty
Absence management, also known as leave management, is a combination of employer policies, procedures, or programs designed to handle employee leaves of absence and minimize the impact of those absences on the employer.
Absence management programs aim to maximize productivity by supporting an employee from initial absence through return-to-work and stay-at-work plans.
Primary Care Case Management (PCCM), is a program of the United States government healthcare service Medicaid.
It oversees the United States system of managed care used by state Medicaid agencies in which a primary care provider is responsible for approving and monitoring the care of enrolled Medicaid beneficiaries, typically for a small monthly case management fee in addition to fee-for-service reimbursement for treatment.
In the mid-1980s, states began enrolling beneficiaries in their PCCM programs in an attempt to increase access and reduce inappropriate emergency department and other high cost care.
Use increased steadily through the 1990s.
