Patients with serious illness often require more intensive medical services coordinated across multiple providers, as well as a wide range of social supports to maintain health and functioning.
Health plans often lack a consistent, structured process for scaling this type of solution across their member populations and geographies. They seek a systemized solution that seamlessly integrates with existing case and utilization management programs to further optimize the consistency of care and the overall care experience.
A Commonwealth Fund survey of patients with complex needs demonstrates the urgent need to apply innovative approaches to management of this population:
47% visited the emergency department multiple times in the past two years
Over 50% did not have access to services to help manage their conditions
62% experienced stress about their ability to afford housing, utilities, or nutritious meals
A home-based palliative care model, the PIM™ program serves health plans, provider organizations and their members who are experiencing a serious illness. Complementing the CareCentrix post-acute care model, PIM identifies, engages and improves the member and caregiver quality of life, reduces over-medicalization and lowers cost.
The PIM program utilizes predictive analytics for member identification and prioritizes the importance of home-based care, arranges appropriate services to address Social Determinants of Health (SDoH), provides clinical assessments / referrals, and partners with physicians to deliver a patient-centered, data-driven, and evidence-based solution.
Proven Return on Quality Improvement & Resource Investment