Payers

Offer specialized programs such as Chronic Care Management to your consumers that need it the most.  ISeeYouCare’s HIE platform can serve as a launching point for your population health and wellness program.

The Challenge

From a payer’s standpoint, having real-time access to the clinical data associated with their beneficiaries for use with their existing loss/risk assessment technologies would be advantageous. Most if not all of the Issuers use “claims” as their primary source of data from which to extrapolate meaningful analysis and subsequent projections regarding future cost or expenses associated with providing medical service insurance benefits to their beneficiaries. While this has been useful and even sufficient to the extent that  given the sophisticated algorithms employed by some of these advanced technologies, they have been able to extrapolate sufficient data from which to be useful in allowing the insurers    sufficient information from which to manage premiums and expenses, resulting revenue generation.

Population Health

Our platform can provide a tremendous benefit to those organizations looking to both reduce healthcare costs and improve the health outcomes for their employees.  By aggregating employee health data, a side benefit of our platform is that employers will be able to perform legitimate data analytics on their employee population, and more accurately assess risks and design programs that will lead to better outcomes for the employee and overall increase in “healthy days” for the entire population.

Chronic-Care Management

Organizations are striving to get a handle on chronic care management. 86% of healthcare costs involve patients with one or more chronic care conditions. Medicare offers CPT Code 99490 for providers who proactively manage their patients with chronic care conditions. ISeeYouCare’s platform can be used by you to manage these patients or we can provide CCM management services for your patients, taking the work out of your hands. This increases your revenue stream and improves patient retention.

Reduce Fraud and Waste

As much as 30% of healthcare costs are wasted, and fraud accounts for an additional $68 Billion per year.  Our Smart Health Card reduces fraud, especially that caused by identity theft.  It follows the same credentials as established by the US Department of Defense.  The system requires three-factor authentication:  possession of the physical card, photo matching of the patient, and knowledge of the password on the account.  Additionally, our platform meets all FIPS 140-2 guidelines and has AES 256 encryption on all data at rest and in transit.

By building a single longitudinal patient health record, we provide the necessary information for physicians and caregivers to make better health decisions leading to better outcomes. Additionally, our payment reconciliation process is directly tied to the clinical activity of the provider and greatly reduces mistakes and fraud. Our Smart Health Card can be a great benefit to systems looking to eliminate fraud and waste due to their inherent security procedures.

Introducing, the CPH Model

ISeeYouCare has developed a unique business model for marketing to hospitals and subsequently, insurance companies using our all-inclusive eTelehealth eco-System. The technology/service solution is called, the “CPH Model”, where each of the characters stands for:

Community-based, Patient-centered, Health-delivery Network

The premise is simple, take the cost associated with managing a hospital’s 30-day re-admission program which represents an expense and flip it over on the balance sheet as a revenue making program. The strategy for this involves three separate health delivery programs.

  1. 30-Day Re-admission Cost Mitigation Program (Un-reimbursed Expense to Hospital)
  2. In-Home Monitoring of Chronic Illness Populations (New or expansion of existing – Revenue)
  3. eTelehealth Consultation Program (New or expansion of existing – Revenue)

The benefits of taking on this program are significant:

  1. Cost mitigation while achieving the much-sought after “Triple Aim” (Clinical Component)
  2. New Revenue Generation using existing human resources (Financial Component)
  3. Capture and retention of patient populations (Marketing Component)
  4. Seamless integration with existing EHR’s and supporting 3rd party claims processing
  5. Potential for new and even higher reimbursements from insurance companies

Contact us for more information about this strategy.

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