We use a variety of levers to drive savings, including:

  • Utilization Management: We reduce post-acute care utilization (e.g. SNF days/1,000) by ensuring that appropriate utilization of post-acute services at the right site occurs across the entire post-acute continuum.
  • Hospital Readmissions Reduction: CareCentrix provides all-cause readmission management, addressing the broadest population at risk for readmissions. The majority of readmissions come from members discharged home without any services; programs that only focus on managing inpatient post-acute care facilities do not address this need. Our programs provide outreach to all members discharged from hospitals and post-acute care facilities.
  • Payment Integrity: CareCentrix evaluates all claims for fraud, waste and abuse and coordinates recoveries with clients. In addition, we scrub claims for payment accuracy and perform service validation calls to ensure services billed have been delivered.
  • Administrative Costs: Our clients realize a reduction in overall administrative expenses. These savings are a result of CareCentrix assuming operations accountability associated with utilization management and related functions (including call centers, denials, and letters) and if delegated, network related costs.
  • Network Management: Optimization of networks can reduce readmissions as well as drive unit cost savings.

CareCentrix has highly competitive and flexible pricing options and stands at the ready to meet the needs of our clients to maximize anticipated outcomes of our post-acute care program.