SERVICES & SOLUTIONS
Conifer Health uses our Population Health Intelligence Platform to provide care teams and plan administrators with secure, web-based access to comprehensive clinical and financial information they need to manage health for a population. The platform integrates clinical data and other data from multiple sources. It also gives users easy access to disease registries, gaps in care, predictive analytics, population risk stratification, hospital admission data and referral data. The platform is also connected to a data warehouse that stores and organizes vast third-party information into a highly efficient, well-organized resource. The powerful reporting engine tracks clinical outcomes, provides feedback to facilitate the management of individuals across the care continuum, and provides tools to effectively monitor individuals at all levels of risk. The platform also feeds our Population Health Portal, Participant Portal and Provider Portal.
Our Medical Management services combine people and information to create a highly personalized and effective approach to acute care management, chronic care management, utilization management and wellness. Accurate, integrated data is used to identify at-risk patients and analyze gaps in care, automate clinical workflows, track results and support continuous improvement. The result: patients experience fewer emergency and hospital visits and better overall health.
Risk stratification tools identify the sickest of the sick for appropriate prioritization, intervention and care management. This tool uses demographics, medical conditions, care patterns and resource utilization to stratify patients into one of five categories: healthy, healthy with conditions, chronically ill, high risk and episode of care. This facilitates medical management and physician decision-making, identifies clinical interventions based on governance decisions, promotes accountability, and assists in determining appropriate healthcare services.
Our Predictive Analytics tool models medical conditions within a population and identifies potential high-risk patients before they need expensive care. It determines health risks by assessing past provider visits and medical conditions/diagnoses, major episodes of care, case and disease management activities, prescription and refill patterns, and clinical claims. Predictive Analytics help determine where medical dollars have been spent in the past and where they’re likely to be spent in the future.
The goal of our Care Team Coordination services is to create a strong, collaborative team that includes the patient, personal health nurse, and the primary care physician and other specialists as needed. After assessing the patient, the care team creates a health and treatment plan to manage current conditions, address future issues before they become an episode of care and support health and wellness. The team is supported through our Population Health Management portal, which aggregates and shares information in real time, assists in implementing health and treatment plans, integrates protocols for prevention, and interfaces seamlessly with the electronic health record to foster effective collaboration.
Our Population Engagement services lead the industry in getting patients actively involved as partners in their own health. By building supportive, long-lasting relationships, our personal health nurses achieve an 82-percent engagement rate with patients—compared to industry benchmarks of 25 percent initial participation and only 7 percent long term. Our success is based on using data to identify participant needs; fostering an active relationship among the nurse, patient and primary care physician; to the extent possible that the same nurse works with the patient and provides ongoing oversight even after an episode of care is closed.
TECHNOLOGIES
Conifer Health’s Population Health Intelligence Platform provides care teams and plan administrators with secure, web-based access to comprehensive clinical and financial information they need to manage health for a population. The platform integrates clinical data and other data from multiple sources, giving users easy access to disease registries, gaps in care, predictive analytics, population risk stratification, hospital admission data and referral data. The platform is also connected to a data warehouse that stores and organizes vast enrollment and paid-claims data from insurance companies, third-party administrators, benefit administrators, pharmacy, laboratories and payers into a highly efficient, well-organized resource. The powerful reporting engine tracks clinical outcomes, provides feedback to facilitate the management of individuals across the care continuum, and provides tools to effectively monitor individuals at all levels of risk. The platform also feeds our Population Health Portal, Participant Portal and Provider Portal—for instant, secure access to information to better manage patient care, control costs and maximize outcomes.
HOW WE'RE DIFFERENT
URAC-accredited medical management software and services
We're a URAC-accredited provider of health utilization management and case management services, and vendor certified for case, disease and utilization management by the URAC*.
*URAC Accreditation through InforMed Medical Management Services, a Conifer Health Solutions company
Ranked as an early leader in population health management organizations in 2013
According to the KLAS® report, “Population Health Management 2013: Scouting the PHM Roster,” Conifer Health received the designation of “early leader” based on our portfolio of solutions.
Focus on accountability and outcomes
Our integrated, real-time data empowers the entire care team to be fully engaged and focused on results. Transparent clinical and financial information make it easy to track the progress of specific interventions and manage the patient to the best possible outcome.
Supports national evidence-based medicine (EBM) guidelines
Supports all levels of medical management interventions, including utilization review, case management and disease management. Integrates clinical and evidence-based medicine protocols and condition-specific clinical guidelines from the National Guidelines Clearinghouse, Centers for Disease Control and Prevention, Medline and professional societies.
Experienced nurse managers
All personal health nurses are registered nurses with at least three years of clinical experience. When they qualify for testing, they attain certification in case management or utilization management.
A proven track record
Our medical trend rate is significantly below published national standards—averaging less than 4 percent—with a 4.5-to-1 return on investment achieved by reducing hospital admissions, length of stay, and emergency room visits.
Real-time information through user-friendly web portals
Customized web portals give providers and plan administrators access to the clinical and financial data they need to manage the population. Participant portals empower patients with tools and information to improve their health outcomes as an active member of their own care team.