NEW YORK–(BUSINESS WIRE)–MagnaCare, a health plan services company with national reach, announces the release of a White Paper significant to the health care industry and reform efforts nationwide: “The New Face of Chronic Care Management” explores the new paradigm of chronic care management in which coordinated specialty care helps to prevent minor health problems from becoming catastrophic and costly health issues.
“Traditionally, chronic care management has involved health care providers educating patients about their chronic diseases”
“Traditionally, chronic care management has involved health care providers educating patients about their chronic diseases,” says Joseph Berardo Jr., president and CEO of MagnaCare, pointing out that chronic disease affects approximately 133 million Americans regardless of their age, race, or economic status, and, in coming decades, that number is estimated to increase by 37 percent. “Given the emphasis on cost and the failure to address the complexity of chronic conditions, this model has not worked. Today, we understand that truly coordinated care across multiple settings is the key to improving care or controlling costs.”
“The New Face of Chronic Care Management” demonstrates how this approach can lead to a 20 percent reduction in health care costs per member enrolled in a chronic care management program, with patients experiencing better health and fewer costly emergency room visits, hospitalizations, and other major medical episodes.
Effective chronic care management serves the guiding principles behind health and wellness reimbursement by:
· Controlling costs through improved health status of members
· Utilizing claims, lab, and pharmacy data to identify opportunities to improve member health status
· Prospectively applying medical management processes to the population
· Selecting individuals who will benefit from intervention
· Incenting providers to participate in the process
The document further discusses the main objectives of chronic care management to transform member data into actionable information; create insights to target root causes of poor outcomes and high costs; design programs that empower consumers and improve outcomes; and develop provider incentive to support behavior.
“The challenges in chronic care management are ever present, the biggest being how to induce consumers to take an active role in their own health care and how to incent providers to engage patients,” Berardo concludes.
MagnaCare, a health plan management company, is proactively reducing the cost of healthcare by offering self-funding options for employers of every size – as few as 15 employees. For more than 20 years, MagnaCare has served commercial employers, health insurers, workers compensation and auto carriers, TPA’s, government entities, and labor markets. MagnaCare offers access to a high quality broad provider network, predictive modeling analysis, member outreach programs or an integrated solution that includes full plan management services. Services include claims adjudication, population management, client/customer service and a full suite of ancillary products.