Managed Care

6 Keys To Successful
Managed Care

Key 1: Referral Reductions

Effective primary care in a managed care environment reduces referrals. Here’s why. When providers spend extended time with patients, they develop care plans that address health issues before they become chronic or acute. As a result, the vast majority of care is handled in the patient’s home clinic.

Key 2: Delivering Outcome

Managed care is no longer simply about cutting costs, an approach that’s a thing of the past. Today it must also drive health outcomes for patients. One way to achieve this is by getting patients into their primary care clinic more often. This is best achieved by robust engagement activities, especially in an employee environment.

Key 3: Removing Barriers

Managed care must reduce barriers to better healthcare, not add them. Effective managed care doesn't shift costs to patients through tactics such as high deductible health plans. Instead, it acknowledges that employer investment in the right kind of care will drive down overall costs.

Key 4: Holistic Solutions

Effective managed care focuses on treating the whole patient. Modern medicine knows that there are connections between mental, emotional, and physical health. By addressing every aspect of patient health, we can ensure that patients have the best health outcomes.

Key 5: Reduced Medication Costs

Medications continue to be a significant driver of increased healthcare costs. In a managed care environment, providers focus on addressing root causes rather than simply prescribing medications to address symptoms. In addition, when medication is needed, a managed care approach encourages the provider to prescribe the most effective option.

Key 6: On-Site Better Than Distant

Convenient access is a significant contributor to the success of a managed care approach. Locating clinics close to patients increases the likelihood that a patient utilizes primary care early and often. This is especially true when care is employer-funded.

Vera Managed Care Distinctives

Behavioral health and behavior change techniques are embedded into the daily flow of our whole health engagement model.

We utilize risk stratification, patient registries, referral management, and information exchange — so our providers are well-equipped to make the best real-time decisions for seamless care management.

Health behavior change directly correlates individual health with peer-group health. As byproducts of our environments, it is imperative to leverage organizational culture to improve population health.

An In-Depth Look At
Managed Care

Managed care is an essential strategy for employers. The best managed care approaches use a proactive, preventive approach. They shift the focus from a “sick care” system fixated on diseases and expensive pharmaceuticals to one that achieves optimal population health.

In this model, employees, spouses, and children receive nearly all the care they need at their home clinic: including primary and acute care, workers’ compensation treatment and occupational health services, and wellness services. They will rely less on emergency and urgent care, rein in complications due to chronic illness, and live healthier lifestyles.

By combining on-site medical care, health coaching, and sustainable culture change with robust analytics, managed care empowers employers to effectively manage healthcare costs. The innovative healthcare strategy known as the “Triple Aim” underpins this philosophy of providing the right care at the right time and at the right price.

Our experience has shown that the following performance indicators drive success:

Patient-centered medical home model principles, with improved patient accessibility
Health engagement for all patients, improving the risk stratification for the entire population
Relationship-based, integrated care including a face-to-face health coach on the clinical team
Real-time data analytics for improved care coordination and continuity for patients
Organization-wide behavior change to support health and wellness

Today’s managed care utilizes an innovative consumer-driven medical home model. This model creates a new patient experience. It provides accessibility, an improved experience, an integrated care team, and the highest quality — all for the lowest cost.

An integrated care model results in significant reductions in employee health claims. ER, inpatient/outpatient, specialty services, and labs/Rx see the biggest reductions. This allows employers to drop ineffective and expensive carrier-based disease management and wellness programs. And it generates cumulative savings over time.

Health coaches are key members of the clinical team, an integration that achieves “whole person” care. The coach also co-facilitates your Whole Health Council. The council is designed to shift your culture to one that promotes total social, mental, and physical well-being.

In the best cases, both providers and the patients are incentivized to achieve improved health outcomes. Unlike traditional hospital-based systems, where physicians are paid based on volume, Vera providers are compensated based on clinic performance metrics; medical outcomes, patient satisfaction, and clinic engagement.

Learn more
About Managed Care

Resource

Two Truths About Patient Engagement

In this study, we looked at 4,118 participating patients at Seattle Children's Hospital over the course of six years. 46% of these patients used the Vera on-site clinic. The remaining 54% did not.

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