When an individual is diagnosed with a serious disease or chronic illness such as cancer, diabetes, musculoskeletal disease or cardiovascular disease, it’s common to feel overwhelmed or burdened by the onslaught of information, medications and treatment plans. Plus, complex conditions often mean multiple appointments and specialists, and the last thing a patient wants to do is answer the same list of questions at every doctor visit.
Although this run-through of questions may be a standard procedure, research from the Council of Accountable Physician Practices (CAPP) shows that patients want their healthcare providers to have up-to-date medical information. According to the CAPP research, patients rank care coordination as a top priority and they expect their medical providers to have complete and current medical information—regardless of where they receive care.
That’s why complex care management (CCM) is critical for patients with chronic illnesses. With CCM, patients get a personalized care plan developed with their specific needs in mind—as well as a specialized team that’s equipped to help navigate complex conditions. When healthcare providers have access to good data that’s updated regularly, they don’t have to repeatedly ask questions. And when health plans have access to that data, care managers can help patients with chronic diseases make educated decisions about their care.
For example, Lucent Health extracts data from providers on a nightly basis, keeping plan administrators or care managers informed. If a patient with diabetes misses her hemoglobin A1C test, the care manager will know by the next day and can contact the patient to reschedule the test. If a patient is diagnosed with cardiovascular disease, the care manager will know by the next morning and can reach out to provide guidance for next steps. Plus, with access to daily data, employers and their third-party administrators can reduce costs along the way instead of waiting until after treatments are completed and charges have been incurred.
The Narus Continuous Observation, Reporting, and Enrollment (CORE) Service is fundamental to the success of the Narus CCM member experience. This required feature drives the technology and analytics engine that allows for smarter, more meaningful engagement. This fee also covers MPOWER mobile app access for all eligible adult members.
Continuous observation refers to daily analysis of all claims activity. In this process, member claims are repeatedly analyzed and assigned risk scores based on a proprietary algorithm. At-risk members automatically undergo a manual review by our clinical staff, providing a second hands-on screening to make the determination of outreach/enrollment.
Reporting service includes detailed monthly client reports not only of the overall member population, including risk assessments, but also of detailed data pertaining to direct Narus engagement, member issue resolution, program utilization and various performance metrics.
Included in the CORE service is all enrollment activity. Regardless of the number of at-risk members or the number of attempts made to enroll/consent, this service is fully provided within this fee.
Lucent Health combines best-in-the-industry claims management with a compassionate, human-focused, data-driven care management solution. Find out more about Lucent Health and our approach to care management. Contact us today.
To hear more about how three companies were able to generate meaningful, sustainable savings for their businesses, while ensuring that employees were taken care of, watch our Webinar: Lucent Health’s Concierge and Complex Care Management Powered by Narus Health.