Alicare Medical Management, one of the nation’s leading care management solution providers, is now utilizing Benefit Informatics’ Advanced Clinical Data Analysis and Reporting platform to provide tools to assess and manage risk and help predict future costs. The technology integrates the award-winning Johns Hopkins Adjusted Clinical Groups (ACG®) System predictive modeling engine and benchmark data set.
“We are excited to be able to offer our customers this additional data analytics solution to help identify high-risk and high-cost individuals early on, and target the most appropriate patients for case and disease management,” says Claire Levitt, president of Alicare Medical Management. “This tool helps forecast utilization and cost based on risk stratification, and pinpoint gaps in care. The flexibility of the Benefit Informatics application allows us to integrate plan data – such as medical claims, utilization management data and pharmacy data – from multiple sources into one consolidated data warehouse to create a comprehensive view of benefit plan trends and cost drivers.
The new platform equips Alicare Medical Management with the tools to generate more summary information and customized reports for its clients, providers, patients and other key stakeholders. By leveraging this new data-rich reporting paradigm, Alicare Medical Management can target high-risk patients sooner and more effectively manage chronically ill populations.
Alicare Medical Management provides a 24-hour Nurse HelpLine, Utilization Management, Maternity Management, Case Management, Disease Management, Health Coaching and Wellness, Independent Physician Review, Medical Claims Review and Hospital Bill Auditing. The company also holds four URAC accreditations for Utilization Management, Case Management, Health Call Center and Independent Review.
According to Philip Kurtz, president of Benefit Informatics, “We are very pleased to provide Alicare Medical Management and their customers a proven data analytics platform to identify, monitor and proactively manage plan costs. Alicare is one of the leading care management firms in the nation and is noted for offering enhanced services and technology like ours to give their customers the greatest value.”
For more information about Alicare Medical Management’s services, visit www.alicaremed.com.
About Alicare Medical Management (www.alicaremed.com)
Alicare Medical Management (AMM), a member of the Amalgamated Family of Companies, is a national leader in developing care management solutions that promote cost savings and patient satisfaction. AMM’s call center is open 24 hours a day, 365 days a year to provide maximum access and assure optimum program effectiveness. The company’s services include: 24-hour Nurse HelpLine, Utilization Management, Maternity Management, Case Management, Disease Management, Health Coaching and Wellness, Independent Physician Review, Medical Claims Review and Hospital Bill Auditing. AMM holds four URAC accreditations for Utilization Management, Case Management, Health Call Center and Independent Review.
About Benefit Informatics (www.benefitinformatics.com)
Benefit Informatics Inc., a Benefitfocus company, enables the efficient planning, management and analysis of employee benefit plans through the delivery of online proprietary applications and services to employers, insurance companies, third party administrators and brokers. Benefit Informatics currently serves more than 75 payer organizations, 6,500 businesses and health plans, and more than three million members.
About the Johns Hopkins ACG System® (www.acg.jhsph.edu)
The Johns Hopkins Adjusted Clinical Groups (ACG) System offers a unique approach to measuring morbidity that improves accuracy and fairness in evaluating provider performance, identifying patients at high risk, forecasting healthcare utilization and setting equitable payment rates. The ACG research and development team, characterized by excellence in both research and practice, has been performing risk measurement and case-mix categorization for more than 30 years. Around the globe, ACGs are a standard tool used by several hundred private and public insurance plans, provider organizations, consultants and research institutes.