The Challenge

As the population ages and care moves to the home, reevaluating your DME benefits management strategy is paramount

When members are sent home without identifying the appropriate resources to support them, such as durable medical equipment (DME), it could lead to additional sub-optimal health outcomes and higher costs due to:

  • Delayed facility discharge
  • Lack of supplier coverage, reliability, and competitive pricing
  • Unnecessary hospital readmissions
  • Delayed healing time and reduced quality of life
  • Claims payment management challenges
  • Fraud, waste, and abuse

Support better health outcomes at home with DME Navigator - a single point of care platform.

Adopting a holistic, integrated DME solution with a single point of care platform can make it easier to support healing, and drive better health outcomes by:

  • Simplifying authorization, ordering, and management of DME for providers.
  • Leveraging a network of quality providers for timely delivery, set-up, and support.
  • Effective Utilization Management and credentialed provider networks contribute to cost management.
  • Ensuring payment integrity and identification of waste and abuse.

Program Results

0 PMPY potential savings on average (varies across LOB)1
0 Faster start of care2
0 Reduction in sub-optimal discharge outcomes2

Our Approach

Modernizing DME with a member-centric experience 

CareCentrix has collaborated with Optum to redefine DME benefits management. DME Navigator streamlines the entire process from ordering to delivery and payment, enhancing efficiency and user-friendliness. Our integrated end-to-end solution provides real-time insights, lowers the cost of care, and improves service quality, benefiting clinicians, members, and suppliers. 

The CareCentrix Value

Together with Optum, our comprehensive solution, DME Navigator:

 

Gets the right equipment
during service selection, an EHR (Electronic Health Record) integrated digital DME ordering platform showcases our credentialled in-network suppliers that have been evaluated have been evaluated on service quality, accessibility, and cost effectiveness.

For the right patient need  
using integrated evidence-based criteria, streamlining utilization management (UM) processes, and providing transparency on order decisions at the point of care.

At the right time 
with streamlined digital processes to enhance patient communication, order tracking, and reliable on-time delivery, minimizing delays or missing supplies.

To drive consistent cost savings  
through upstream claims editing and pricing using negotiated, competitive rates.

Strategies that work.
Savings you can count on.

Sources:
1. CareCentrix and Optum joint analysis of savings potential based upon current market data. Potential estimated savings (%) will vary by health plan and actual potential savings will be updated after a specific health plan data run.   2. Parachute Health data analysis; 2023