Over the years, health management has continually evolved. MedCost has always responded to industry changes with program refinements and new offerings that have kept us on the cutting edge of health management. With every change, however, our priorities have remained the same: effective cost management and quality patient care. Now, these enduring priorities have led us to focus squarely on the things that create the highest impact—proactive ways to help people stay healthy, and the early identification and management of complex, high dollar cases.

Strategic Health Management
MedCost’s “high impact” imperative is best reflected in our innovative new care management package. Philosophically, care management focuses, first and foremost, on managing the needs of patients, not just managing their conditions. Care management addresses patients as unique whole persons, evaluating their needs and responding with customized planning and coaching to improve health status.

Care management’s suite of programs work together, integrated and coordinated by the electronic exchange of information, including claims and prescription drug data from claim administrators. Using a claims modeling program created by MedCost, the data is analyzed to identify the high dollar cases and at-risk patients that can be impacted most by early intervention. Proactive intervention often means that adverse and costly clinical events can be avoided, creating a positive financial impact for both employers and plan members.

In other words, because care management is both proactive and cost-effective, it is strategic health management.

Core Programs
There are five core components in the MedCost Care Management Package Suite--inpatient utilization management, outpatient utilization management, catastrophic case management, high-risk maternity case management, and a new, innovative component: personal care management.

Personal care management focuses proactive attention on plan members with health conditions which, if addressed early, may not develop into more serious and costly conditions. Personal care management provides mentoring and monitoring for many who would otherwise “fall through the cracks” because their conditions are not serious enough to require traditional case management.

Option
MedCost also offers an optional, additional program—disease management—that can enhance the Care Management package. When all six programs are utilized, the result is total population health management, a comprehensive package of services that addresses every health status found across an entire employee population.

Healthier Members Mean a Healthier Bottom Line
MedCost’s Care Management Product Suite provides integrated options to help keep plan members as healthy as possible. Healthier plan members are more productive, with fewer absences from work or school, and fewer health care claims. Ultimately, better member health is reflected in a better bottom line. MedCost created the Care Management Product Suite for this very reason—to help employers get maximum results from their health care dollars.