CareONE

CareONE DVCP™
Delivering new, standardized clinical approach for ALL plan
members of Medicare Advantage Plans

Given increasing cuts to reimbursement, successful Medicare Advantage Plans (MAPs) must become even more adept at balancing the competing requirements, interests and goals of CMS, members, providers, MLR and the plan’s financial performance. Quite often, decisions and resources benefiting one area represent a negative impact to another.

For example, the practice of retrospective and prospective claim analysis for the
purpose of detecting and documenting diagnoses is viewed positively by plans but negatively by CMS. Further, of itself, the process does very little to improve member care. It is actually very rare that MAPs are presented with a product or service that simultaneously benefits all parties.

That said, every once in a great while, a breakthrough does occur.

Enter CareONE DVCP™ – Diagnosis, Validation and Care Plan generation. A new service for MAPs that will truly elevate Medicare Advantage to an unprecedented level of efficiency, effectiveness, member value, purpose and national acceptance as the bona-fide antidote for traditional fee-for-service Medicare. CareONE DVCP™ is an amalgam of tried and true processes under a single wrapper and volume augmented by technology. In this view, CareONE DVCP™ represents a means of truly achieving CMS’ Three Aims – (1) better care, (2) healthier people/healthier communities, and (3) lower costs through improvements.

The Premise Behind CareONE DVCP™

• An Annual Wellness Assessment & Comprehensive Exam to Detect Illness and Risks
• Targets ALL of Your Medicare Advantage members
• Uniform Documentation, Identification and Annual Reconfirmation of Diagnoses
• System-based Output of HCCs and RAF Codes
• AccessONE™ Tool Provides Drill-Down Analytic’s Into Actual Present Day Risk for Intervention of Chronic/High-Dollar Claimants, Star “Events”, CAHPS and more.

Components of our Program

• Identification of early stage illnesses/conditions
• Improved care and quality of life for members
• Early stage detection = decreased cost of care
• Accurate alignment of CMS premiums with member morbidity
• Better controlled risk = greatly improved margins
• Direct impact on Star Ratings
• Highly meaningful touch point for members
• Access “actual” population risk exposure data

Summary

When released, the WellTrackONE and its proprietary CareONE DVCP™ program can change the face of Medicare Advantage. It will give risk-based Medicare organizations a solid platform for risk/diagnoses detection, data aggregation and early detection of chronic disease and predisposition for catastrophic injury. Costs will be reduced through early intervention and care plan delivery, while revenues will increase as plans are reimbursed commensurate with true levels of member morbidity. Plans utilizing our system will attain a competitive advantage through knowing their actual risk exposure – enabling more accurate bids, adjusted stop loss insurance and more. At the same time, retention will increase as members attribute unprecedented value to “their” Medicare Advantage Plan. CareONE DVCP™ is a game changer for Medicare Advantage Plans – for members, plan sponsors and CMS.

To learn more about this product that is soon to be released by WellTrackONE, please Click Here.

Learn More About Clinical Triggers™

Learn More About AccessONE™

CareONE Employer Program™
Delivering new, standardized clinical approach for ALL Employees

Healthcare is the second highest employer expense and no matter how low a company’s annual increases are, the carrying cost of health benefits represents a major loss of profit. According to the Centers for Disease Control and Prevention (CDC), U.S. employers lose more than $225 billion each year in productivity due to employee health problems. Today, health inflation and a health system based on illness treatment instead of illness prevention, conspire against company profits and every employee’s health. Routinely companies are forced to accept this as the status quo, with no solution for the increasing cost of healthcare.

Today there is a new way for employers to gain control of this growing cost.

Introducing the CareONE Employer Program™ – a new service for companies with self-funded health benefits that will enable them to take a greater control of their healthcare costs, while enhancing the quality of life of their employees.

CareONE Employer Program™ is an amalgam of tried and true medical practice combined within a single program and augmented by technology. In this view, CareONE Employer Program™ is a program that allows self-insured companies to better control their health spend and obtain far greater vision into their health risk profile.

Learn More About Clinical Triggers™

Reclaiming Profit Held Hostage by Health Benefits

• Routinely accepting the status quo of continued high benefits costs and yearly increases is not acceptable
• As the second highest employer expense, no matter how low your annual increases are, the carrying cost of health benefits is a major loss of profit.
• Health inflation and a health system based on on illness treatment instead of illness prevention, conspire against company profits and every employee’s health.
• Increased employee cost sharing hurts retention and is not a sustainable solution
• Basic, long-established medical practice optimized by WellTrackONE technology is the answer

Summary

WellTrackONE and its soon to be released proprietary CareONE Employer Program™ is a significant solution in helping self-insured companies to make informed decisions and control their healthcare costs.

To learn more about this product that is soon to be released by WellTrackONE, please select Click Here.

Learn More About AccessONE™