A Vital Piece

The value of medical management in integrated healthcare.

Historically, healthcare benefits operated in "silos" - each offered independently with little or no interaction among them. This means lines of healthcare coverage, for example medical, pharmacy, and vision, were administered separately. This led to an incomplete picture of an employee's health.

Recently a rise in integrated healthcare has been working to change this. By bringing lines of coverage together, the data from each is transformed into real insights. This can provide a more complete picture of health and help identify gaps in care.

"This sort of integration can help increase employee engagement with their benefits, deliver better health outcomes, and lower the cost of care," says Brenda Gain, Director II, Medical Management at HealthLink.

However, as integrated healthcare models gain popularity, a vital piece of the healthcare puzzle can be overlooked.

"Simply integrating all lines of coverage under one vendor isn't a complete solution," says Gain. "To truly impact the cost of care, a robust medical management program must be included into the integrated healthcare solution."

Here are the top three reasons that medical management is a vital piece of integrated healthcare:

Identify chronic disease earlier and engage employees sooner

The main objective of a medical management program is to help identify potential health concerns before they become an issue. Whether it's a pre-certification request for a hospital stay, or a claim that triggers case management outreach, a medical management program is a crucial resource for proactively managing high-cost health conditions.

Better condition management

With a medical management program in place, employees are engaged one-on-one with the education and support they need. If an employee is suffering from a chronic condition, or getting ready to have a major surgery, medical management can help them prepare and manage their health.

Care managers can direct them to other services and benefits

When an employee is engaged in medical management services, they are connected to the complete portfolio of health and wellness resources available to them. For example, if an employee is enrolled in the case management program for diabetes, their case manager can connect them with useful information and tools to help them manage their condition. The case manager also has the opportunity to address other conditions the employee may be at risk for.

While integrating lines of healthcare coverage can have a big impact, a strong medical management program cannot be overlooked when working to manage the total cost of care.

For more information about how a medical management program can impact your company, contact HealthLink at Sales-AcctMgmt@healthlink.com.

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