CASE STUDY
Multi-National Manufacturer Focusing on 40,000 Regional Employees
Engage high-risk members to promote primary care utilization and better benefit navigation with Conifer Personal Health Nurses (PHNs)
How We Helped
- Deployed community-based PHNs to facilitate conversations and discover opportunities to coordinate care and eliminate barriers
- Launched multifaceted outreach campaign to raise program awareness, including print, web and social media as well as virtual health fairs
- Navigated members to the proper level of care, including bi-directional referrals with behavioral health benefit provider
85%
Member Engagement
95%
Member Satisfaction
3.14:1
Return on Investment
Lower Cost of Care. Better Health Outcomes. Exceptional Member Experience.
Our Population Health Management solutions leverage data aggregation, risk stratification and care coordination to deliver better health outcomes. We are passionate about caring for the people that power your business.
Member advocacy drives improved health outcomes
Conifer Health’s Personal Health Nurse solution provides an individualized approach to population health management – going beyond episodic case management or chronic condition management we help members navigate the care continuum to find the right care, in the right setting, at the right time.
Our solution includes:
- Dedicated one-on-one collaboration and care planning with a Registered Nurse
- Interventions that coordinate care, medications and available benefits and resources
- ConiferCore® technology prioritizes highest risk members for outreach and engagement
- Integration with health plans, pharmacy benefit managers, third-party administrators, healthcare provider networks and other benefit solution vendors
Key benefits:
- Manage the cost of care for your organization and members
- Educate members to better utilize healthcare and other provided benefits
- Member-specific health goal tracking and reporting
- 97% member satisfaction rate
Relationship-based approach to a robust clinical program
Conifer Health’s Case Management solution encompasses more than reactive involvement in expensive acute care episodes – powered by ConiferCore® technology, our Personal Health Nurses seek to support your members most at-risk to become a high-dollar claimant or ineffective benefit utilizer.
Our solution includes:
- Registered Nurses with diverse clinical setting experience and continued education
- Facilitation of member and provider interactions to reduce the risk of fragmented care
- Member-centric goals for smarter health-related behaviors and improved health outcomes
- Assess other demographical, social and non-medical factors
Key benefits:
- Manage the cost of acute condition care for your organization and your members
- Engage members to take an active role in their healthcare
- Eliminate frustrations and waste in healthcare consumption
Goal-based program cares for the person, not just the condition
Conifer Health’s Disease Management solution identifies members most at risk for disease progression utilizing ConiferCore® Diagnostic Class Hierarchy – placing those members with Personal Health Nurses who educate and empower members to take charge of their own health.
Our solution includes:
- Customizable programs to target specific chronic conditions and/or complex comorbidities
- Industry-standard clinical protocols built for collaborative care models
- Member education about the importance of adhering to their care team’s treatment plans
- Disease-specific care guide kits and communications to promote self-management
Key benefits:
- Manage the cost of chronic condition care for your organization and your members
- Establish effective utilization patterns and medication adherence
- Availability of a trusted resource when your members experience a time of need
- 70% of engaged members meet the program’s goals and move into self-management
Maximize member access to the most appropriate care
Conifer Health’s Utilization Management solution positions your organization to not only focus on cost containment, but also your members’ access to the right care, in the right setting, at the right time.
Our solution includes:
- Dedicated nurse team with in-depth understanding of your organization’s benefit plan
- Proven practices to close gaps in care and transition members between levels of care
- Determinations informed by evidence-based medicine guidelines
- Comprehensive Concurrent Review with admission screening and discharge planning
Key benefits:
- Low appeal and overturn rates
- Identify utilization patterns and trends impacting medical spend
- Transition highest-risk members into longer-term care management programs managed by Conifer Health’s Personal Health Nurses
Transforming lives one member at a time with Conifer Health
Conifer Health’s Member Stories showcase remarkable journeys of individuals who have overcome challenges and achieved much improved health outcomes through the life-changing impact of our Population Health Management solution and dedicated Personal Health Nurses.
Conifer Health is URAC accredited for Case Management Services (with Transitions of Care Designation) and Health Utilization Management Services.*
*URAC accreditation through Conifer Care Continuum Solutions, a Conifer Health Solutions, LLC
