Integrate care management silos

As a healthcare payor, you need to ensure that members receive optimal care with the greatest efficiency. To accomplish that, you need to eliminate the silos of utilization, case and disease management operations – and open the data highway in collaboration with other healthcare stakeholders.

CareEnhance® Clinical Management Software (CCMS®) is a convenient, efficient and customizable workflow solution that strengthens your staff and increases provider satisfaction. CCMS helps you to decide where to focus your resources, better coordinate care, integrate data within your workflow and plan appropriate interventions.

CCMS offers an intuitive design, automated tools and customizable features that leverage the unparalleled InterQual® evidence-based clinical content that most customers choose to include, all supported by our professional services, to give you the power to improve care management. CCMS uses proven InterQual criteria to help you make consistent care decisions to improve outcomes and meet regulatory standards.

Benefits

• Enables you to predict and identify members with potentially high costs so you can help them manage their health, sooner
  
  
• Includes tools to track outcomes and identify program improvement opportunities, leading to better quality and lower costs
  
  
• Reduces your administrative workload and duplication of effort to drive down administrative costs
  
  
• Integrates data from internal and external sources to help ensure a consistent, comprehensive view of each of your members

CCMS, a modular solution, has three components:

• CareEnhance Care Manager
  Combines case, disease and utilization management into a seamless process and improves communication among care managers for better outcomes.
  
  
• CareEnhance Care Strategies
  Provides a set of case and disease management standards to help case managers provide optimal treatment consistently for specific high-cost, high-prevalence conditions.
  
  
• CareEnhance Disease Monitor
  Uses medical and pharmacy claims to identify and monitor chronic diseases early, when interventions can be most beneficial.

Do you want to know more about CCMS or its components? Call us at 800.782.1334 or request more information.