EFFECTIVELY PROVIDING CARE FOR PATIENTS

Effectively providing care for patients while managing expenses can seem an insurmountable challenge. In fact, increasing quality care and reducing expenditures might even seem to be incompatible goals. With OptumHealth Case Management, however, these two goals are achievable.

Meeting the Needs of Patients

A collaborative process, Case Management assesses and coordinates services to meet individuals’ health needs: ensuring smart decisions are made based on evidence-based guidelines. Through education, empowerment, support and advocacy, we help patients reduce costs and experience a higher quality of life. By reducing unnecessary services and procedures, unnecessary hospital admissions and lengths of stay for inpatient care – as well as redundancies in outpatient services – we can help save you money as well.

Driven by eSync Technology

Our end-to-end clinical platform, eSync, drives total population health optimization by promoting a healthier culture and long-term health care value for all populations. eSync enables:

• Total population monitoring by synchronizing diverse data components, including clinical, self-reported, behavioral, disability and lifestyle information.
• Proactive health care management by constantly scanning the entire population to identify opportunities for intervention before major health events occur
• Personalized messages in preferred communication modes, along with access, tools and information
• Provider engagement by providing a holistic view (with member permission), care recommendations, data sharing, incentives and referrals
• Clear, concise reporting through a consolidated view into operational, activity and economic performance of your investment as well as population insights Solution Sheet

Engaging Three Components to Meet Diverse Audiences

Our Case Management Services include three components:

• Transitional Case Management evaluates and coordinates post-hospitalization needs for members identified as being at risk of re-hospitalization or as frequent users of highcost services.
• General Condition Management services individuals with chronic conditions, those in need of longer-term support, or those who have unmet access, care plan, psycho-social or knowledge needs.
• Complex Case Management deals with catastrophic cases needing coordination of multiple providers, access to community resources or longer-term support or those having complex access, care plan, psycho-social or knowledge needs.