Care Management System
 

Care Management System -our web-based HIPAA-compliant medical record system that supports our care management functions.  The system is a feature-rich medical records system, with modules for all care management activities to include acute care, disease management, complex case management, health coaching and care coordination..

The system facilitates trend management using a method called predictive modeling to analyze a company’s entire population.  This allows us to maximize outcomes proactively by identifying highest-risk members as well as those trending toward a need for additional healthcare resources.  Our software and high-touch approach enable us to track members’ movement in and out of risk levels, the presence or absence of disease, the level of condition specific compliance, plus other data analysis and trending as needed.

The Healthgram system’s capabilities include the following and more:

  • Supporting our medical and health-based educational programs 
  • A robust patient chart (the dashboard) with all patient information on one screen; including claims, Rx, labs, encounter history, conditions, diagnoses, and more
  • Storing all encounter data; HRA information; Rx, claims, and lab data collected during on-site and/or telephonic outreach
  • Storing, integrating, and archiving all member data collected over time
  • Tracking all activity, compliance, behavioral, and medical outcomes at the member and aggregate level
  • Housing all member data, which allows us to provide total population management
  • Producing reports for the stratification of highest to lowest risk
  • Driving all reporting and predictive modeling 
  • Generating medical and financial trend analysis
  • Allowing for data mining to ensure program effectiveness

 

 The Dashboard:

 CMS dashbord




 

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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Prevention Management

Health Advocates support plan members by
educating them on the importance of early
detection, prevention and primary care
bonding.

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