Prevention Management
 

Prevention Management aims to combat poor healthcare utilization by averting overuse and underuse of the healthcare system. Both types of behavior lead to negative health outcomes and unnecessary costs.  Wellness Coalition America (WCA) utilizes Healthgram® software to integrate self-reported Health Risk Assessment information in tandem with claims data to identify individuals who have not obtained recommended preventive care (based on guidelines from the US Preventive Services Task Force) and individuals who are visiting the emergency department as a result of not having a primary care physician. 
 

  • Adults with a primary care physician had 33% lower costs of care and were 19% less likely to die from their conditions –Johns Hopkins
     
  • At least 60% of deaths from Colon Cancer could be prevented from screenings -CDC
     
  • $38 billion in wasteful healthcare spending is due to overuse of the Emergency Department. –National Quality Forum 


Our team of Health Advocates is dedicated to supporting each member of your health plan by educating them on the importance of early detection, prevention, and proper primary care utilization. Our team is trained to guide members to seek out high value care through face to face or telephonic intervention.  Compliance with recommended screenings and referrals is tracked within the Healthgram® care management system to allow for continuous improvement in the health of your population and your bottom line.

 
Prevention Management Objectives:

  • Primary Care Physician Bonding
  • Reduced Emergency Department Use
  • Increased Compliance with Cancer Screenings and Routine Exams 

 

 

Benefits Administration

Providing totally integrated administrative services
to self-insured employers for over 30 years.
Controling healthcare costs while
delivering exceptional service.

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Case Rate Negotiation

Pre-service negotiation of pricing, before the encounter. Re-directing care to more
cost-effective providers.

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