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Value Based Healthcare Solutions

Medical Benefit Manager (“MBM”)

Value: Provides MBM alternative to PBMs

 

Value: Provides Triple Aim results of lower costs, enhanced quality, and outcomes

 

Impact: Historical range of savings between $40 to $100+ (Per Member Per Month)

Medication Therapy Optimization (Value Based Economic Model)

Value: Uses pharmacogenomics and scalable technology tools

 

Impact: Historical savings reducing total cost of care by at least $300 PMPM in Medicare populations and $100 PMPM in under 65 populations

Advanced Data Analytics Platform

Value: Creates Episodes of Care supporting Clinical Pathways driving lower costs

 

Impact: Identifies, stratifies, and supports in managing risk at lowest cost

Musculoskeletal Pain Mitigation Program

Value: Virtual postural kinetic-chain physical therapy program that can be integrated into self-insured health plans for employees that greatly reduces cost to plan and enhances quality of care for employees/patients

 

Value: Program can be provided to patients through QR code provided during office visit or otherwise provided.

 

Impact: Significant new source of revenues for medical practices and cost savings for your employee health plans.

Cash Driven Health Plan

Value: Delivers an end-to-end experience truly benefitting the member, the employer, and the provider

 

Impact: Better savings achieved through use of a quality medical neighborhood of providers who are paid cash and have significantly less administrative burden to care for plan Members.

 

Comment: Uses cutting edge technology and proven expertise to identify top providers and facilities to deliver care at the highest value with the lowest costs and best outcomes

Gut-Health Solution based upon Metabolic/Microbiome "Food as Medicine"

Value: Provides platform reversing costliest care conditions (pre-diabetes weight management, diabetes, hypertension, hyperlipidemia, digestive and autoimmune).

 

Impact: Mitigates risk and reduces costs in self-insured plan for employees and new source of revenues for medical practices

Direct to Employer (“D2E”) Health Plan Strategies & Solutions

Value: Provides best-in-class fully integrated resource platform to design and deliver D2E & /level-funded healthcare solutions for Healthcare Systems/IDN’s and ACOs.

 

Impact: Provides foundation for value-based care, increased market share and overall margin optimization.

Self-Level Funded Health Plan

Value: Fully integrated platform of best-in-class risk mitigation resource capabilities supporting self-level funded plans for small to large organizations.

 

Impact: Mitigates risk and reduces costs in self-insured plan for employees

Proactive Care Management Platform

Value: Fully integrated platform of proprietary monitoring devices supported by team of healthcare professionals collaborating to ensure no “gaps in care” for each patient.

 

Value: Creates a hospital/health in the home environment at the greatest value (highest quality care management at the lowest cost)

 

Value: Lowers cost of care by oversight of care for patients driving high cost/highly complex care management

 

Impact: Reduces readmission rates historically below 3%.

 

Impact: Mitigates risk and reduces costs in self-insured plan for employees

Self-Insured Dental Plan Platform

Value: Fully integrated platform of resources creating a customized self-insured dental plan

 

Impact: Reduces premium costs between 20% to 40% compared to fully insured plans

Behavioral / Mental Health Services/Platform

Value: Top-tier team leveraged by state-of-art technology optimizes mental health outcomes

Value: Provides personalized holistic care management approach

Impact: Optimizes outcomes and significantly lowers total cost of care

Out-of-Network Claims Management Cost Reduction (Includes Air Ambulance)

Value: Team of skilled/trained Industry best claims negotiators aligned to optimize cost savings

 

Impact: Over 70% discounts realized on Out-of-Network Claims (Includes costly Air Ambulance claims)

Overpayment, Recovery & Compliance Program

Impact: Typically drives 10% to 30% reduction in medical claim spend and effectuates more control over claims without reducing benefits or increasing member costs.

 

Value: Recovers lost plan assets ($$)

Prescription Savings Program

Impact: Typically drives pharmacy cost savings at least 20% on many high-cost medications

 

Value: Alternative sourcing is provided as stand-alone or integrated within pharmacy benefits administration.