Suboptimal Management
Traditional MSO (Managed Service Organization) services include claims processing, provider payment, utilization management (UM), provider/member relations, provider contracting/ credentialing and provider/member database management. Case management is performed without a systematic approach on a very small subset of patients. Thus, case management has traditionally been ineffective and inadequate.
Effective Management
We at Affordable Care Management believe that better outcomes and cost-effective treatment are directly correlated to the effectiveness of the coordinated care management. Our Care Management Program is based on the comprehensive management of appropriately screened patients. Our proprietary methodologies are centered around Focused Integrated Risk Management Solutions (FIRM Solutions) to optimize both patient outcomes and cost efficiencies. FIRM Solutions not only takes Care Management to a new level of treatment optimization for all traditional IPA patients but meets and exceeds the requirements for the new Medicare/Medicaid Duals Programs. In addition, ACO-like quality measures and standards are built into the program.
Cost-Effective Management
Traditionally, tracking cost-effectiveness of care management has generally resulted in "soft outcomes/savings" which are unreliable benchmarks. Affordable Care Management's proprietary system results in tangible savings that are well documented. This emphasis on real cost-effectiveness is added incentive for us to maximize our patient outcomes through our rigorous integrated and coordinated management of the patient's overall treatment as well as primary and secondary prevention. This will greatly improve your Medicare/Medicaid Duals patient management as well as your entire population of covered lives.
