One of the cornerstones of Coordinated Health/CareT is that it encourages members to follow a more effective and efficient process of healthcare through education, targeted incentives in the plan design, and direct intervention by the Care Coordinators.  By adopting this program, employers encourage employees to take a more active role in their health and healthcare services, and provide them the knowledge and tools to do so.

Coordinated Health/Care employs a continuous care management processes best summarized as:
            Be Well.  Stay Well.  Get Well.

Use of Primary Care Physicians
Based on our research regarding how the process of healthcare leads to inefficiency, we believe strongly in the power of utilizing Primary Care Physicians as the patient's "coordinating physician."  Many studies have shown that patients who have a PCP or "regular source of care" access healthcare services more frequently, but have lower overall costs.

Unfortunately, through their forced and bureaucrat use of PCPs, HMOs confused the role of PCPs and even soured many Americans on their importance. In fact,

A recent study showed that only 17% of Americans knew what a primary care physician was.  PCPs are certain specialties of medicine who are trained to maintain a long-term, preventive-oriented relationship with the patient, to evaluate all body systems rather than a certain specialty during initial diagnosis, and to direct the patient to the appropriate specialist.

Through education, gentle reminders and plan incentives, our Care Coordinators help patients understand the importance of PCPs and encourage them to voluntary utilize a PCP.  We ask all patients to designate a PCP as their coordinating physicians, and provide an enhanced benefit for all PCP office visits, but use of a PCP is always voluntary.

Preventive Screening
Coordinated Health/Care also stresses the importance of regular preventive screening for early detection of chronic conditions.  This is accomplished through PCPs and through Health Needs Assessments and work-site preventive screening (blood draws and sticks).  When patients have a relationship with a PCP or family doctor, they are much more likely to have recommended preventive screening at the right time.  We regularly track the percentage of plan members who have had preventive screening in the past 12 months.

Numerous employers have asked us to host work-site health fairs and preventive screening such as blood pressure and blood draws.  We utilize several professional services to conduct these tests, and the results are then sent to the Care Coordinators for appropriate follow-up with patients and physicians.  Since our preventive screening program is not a profit-center, but jut part of the overall Coordinated Health/Care process, we are able to offer these services at significantly lower costs than stand-alone vendors. 

Disease Management: Self-Management of Chronic Conditions
Our goal is early identification of chronic conditions, so we can educate patients and help them self-manage their condition so it does not progress to an acute stage.  Early identification is achieved through preventive screening, Health Needs Assessment that is completed by each new member, and analysis of claims data.

When a patient is identified with a chronic condition that has been targeted for Disease Management, he/she evaluated and classified as Tier 1, 2 or 3 in severity.  Tier 3s receive aggressive case management and assistance in following their physician's Plan of Care. Level 1s received mailed educational material, and Level 2s receive a mix of assistance depending on their needs.  The goal is to help Level 3s move to Level 2, and for Level 2s to move to Level 1, based on effective self-management.