Health Plans

Utilize Health is a specialty care coordination solution that provides a programmatic approach specifically for members with neurological conditions.

Member Identification

Our platform enables health plans to identify health improvement and cost reduction opportunities for their members with neurological conditions.

Condition Expertise

Utilize Health's condition specific care management program has been clinically designed to address a member's phase of care and risk level.

A New Solution

The program is delivered through an effective blend of digital tools and clinician concierge services, engaging these members to be active participants in their health. Payer Focused. Patient-Centric.

Why is this a need for health plans?

While most health plans have some degree of complex case management services, they often need the programmatic approach necessary to reduce costs and improve the health of members with neurological conditions. Utilize Health’s solution does this by addressing their unique health, environmental, and social needs. SIMPLY PUT: We lower claims costs by maximizing each member’s potential for recovery, managing comorbidities, and decreasing or eliminating costly secondary conditions; all while improving overall member satisfaction.

The Hidden Costs of Patients with Neurological Conditions

Specialty programs aren’t typically provided for members with neurological conditions because it’s thought that nothing can be done for these conditions, but recent medical research is changing our understanding of how the nervous system recovers.

The surprising truth is that these members represent up to 4.5% of a health plan’s population, but who’s healthcare costs account for up to 24% of the entire plan, meaning there’s a new opportunity to make a big impact on this population.

Delivering Value

We’re hyper focused on reducing care costs in three core areas that we’ve found have the highest impact:

1

Utilization: Specifically by reducing high-cost drivers like specialty visits and tests such as imaging.

2

Hospital Readmission: Patients with neurological conditions have an 11 in 20 chance of being readmitted every year for an average of 24 days per year. Reduction in this area is critical for reducing care costs.

3

Secondary Conditions: These conditions, such as UTIs, are either preventable and/or manageable. These conditions have to be managed differently because of how they relate to core neurological conditions.

Early intervention allows for efficient and effective care coordination throughout a patient’s episode of care. Getting patients to lower levels of care faster and finding the appropriate and high quality provider sooner reduces costs while maintaining quality.

DECREASE READMISSION RATES

Providing constant support allows for close monitoring of patients, reducing complications.

IMPROVE HEALTH OUTCOMES

Ensure patients are getting the right care, at the right facility, at the right time. Patient education and engagement reduces secondary conditions.

INCREASE PATIENT SATISFACTION

Create a trusted relationship through service and expertise.