Proactive Care Management

Where high-tech meets high touch

What is Proactive Care Management?

Proactive Care Management is a three phase approach impacting healthcare costs and improving health outcomes for all plan members and employees.

PHASE 1

Analytics Consulting

We review your claims, identify cost saving and wellness programming enhancement opportunities.You receive a custom proposal to reduce costs based on your current situation.

PHASE 2

Marketing & Education

You and your team receive communication campaigns and marketing assets, such as animated explainer videos, infographics and live webinars educating your team on your benefit offerings.

PHASE 3

Clinical Coaching

Your care team is armed with member-level claims data, your employee census file and biometric data to identify which employees need ClinicalCoaching outreach and to been rolled in Care Management.

PHASE 1

Analytics Consulting
We review your claims, identify cost saving and wellness programming enhancement opportunities.You receive a custom proposal to reduce costs based on your current situation.
Jump to Analytics Consulting

PHASE 2

Marketing & Education
You and your team receive communication campaigns and marketing assets, such as animated explainer videos, infographics and live webinars educating your team on your benefit offerings.
Jump to Marketing & Education

PHASE 3

Clinical Coaching
Your care team is armed with member-level claims data, your employee census file and biometric data to identify which employees need ClinicalCoaching outreach and to been rolled in Care Management.
Jump to Clinical Coaching

Phase 1: ANALYTICS CONSULTING OVERVIEW

Kadalyst’s health analytics platform provides you with powerful insight into your workforce’s future healthcare spend and current health status. Kadalyst provides you a comprehensive analysis of your health analytics data and conducts a wellness program audit to further assess cost containment strategies and recommendations to establish program goals over the next 12-36 months.

Health Analytics Review
  • Access to your database required
  • 6 Core Areas of Focus:
  • Care Gaps
  • Prevention
  • Medication
  • Claims
  • Biomarkers
  • Utlization
Wellness Program Audit
  • Program Scorecard
  • Employee Benefits
  • Vendors
  • Evaluation & Reporting
Assessment & Recommendations
  • Findings / Overview
  • Broker Q's
  • Interventions
  • Support
Plan Review With Client
  • PDF Version Provided
  • Conference Call Review
  • Q&A

Analytics Consulting: Health Analytics Review

“Gaps in Care” is one of the six core areas of focus we dive into, to determine a more strategic approach to cost saving opportunities. Below is an example of how we might look at your health analytics data and provide recommendations you can adopt.

Sample Recommendations

Provide Disease Management through a vendor to those in the top 3 disease states.

TIP: Pre-inform your team about the outreach so they aren’t caught off guard, and are more likely to complete the call.

Work with your benefits consultant to ensure your health plan provides the necessary coverage to make it easy for members with care gaps to receive care, surgery or medications required

Host workshops or webinars for your employees about the importance of lowering cholesterol, managing diabetes and heart health. Your health plan may also have materials to distribute about the coverage available for these conditions.

Analytics Consulting: Wellness Program Audit

Elevate your wellness program, with a thorough wellness program audit, followed by a comprehensive list of recommendations you can use as a guide for future program planning and budgeting.

Want to learn more about how Analytics Consulting can help you and your team thrive?

Phase 2: IMPLEMENTATION & OUTREACH

Marketing & Education Overview

Our 90-day implementation plan is focused on educating plan members about the new Care Management program; what to expect, who our Clinical Coaches are & what they can discuss, and confidentiality through a comprehensive communication campaign.

Weeks 1 - 3

Management Buy-In

Communication to supervisors regarding program and new incentive plan

Week 3

Video Launch

Informational video detailing: expectations, confidentiality and program overview

WEEKS 3 - 4

Email Campaign

Fun and easily digestible content sent for ongoing education

weeks 4 - 5

Meetings

Structured for employees to share what they have learned and ask questions

week 6

Communications

Additional emails, 1:1 & group phone calls and text messages

Weeks 7 - 9

Live SMS Polling

Communication to supervisors regarding program and new incentive plan

Weeks 10 - 11

Email Campaign

A final push campaign to communicate relevant plan changes, incentive program and upcoming screening events

Week 12

Health Screenings

Educational materials provided during event

Implementation & Outreach: Clinical Coaching Overview

Employee engagement is crucial to gaining traction within any cost containment or health improvement program. That’s why we leverage a variety of data sources and technology to aid our ability to reach the right people at the right time.

IMPORT CENSUS FILE

Demographics, geographics, employment information.(i.e. department, shift time, supervisor, etc.)

REVIEW ANALYTICS DATA/strong> Claims, gaps in care, pharmaceuticals, incomplete preventative screenings, predicted in-patient andER visits.

REVIEW BIOMARKERS & HRA Chronic health problem(s), lifestyle, HRA responses, physical and mental health biomarkers.

DEFINE CONTACT lIST Data is uploaded to contact management system and built-in artificial intelligence predicts the most appropriate time to call and reach members.

ENGAGE MEMBERS

Clinical health coaches begin proactively reaching out to members, referencing the profiles in the health analytics tool.

SERVICE GUARANTEE

We establish mutually agreed upon performance metrics and milestones, that lead to a healthier workforce and lowerout-of-pocket insurance costs. The performance metrics monitored are based on the cohort(s) created within the Springbuk platform and must fall within the acceptable ranges, as agreed upon. Sample performance metrics are provided below.

Phase 3: ABOUT OUR CLINICAL COACHING

Our Clinical Coaches are W-2 employees of Kadalyst. We never outsource or contract with 3rd parties. Employing our own in-house clinicians and health professionals that operate and interact as a “Care Team,” is what leads to our high levels of engagement and employee care support efforts

OUR APPROACH

  • Proactive outbound engagement
  • 24/7 availability
  • Collaboration and review of members
  • Consistent outreach (we don’t stop at just 3 phone calls)
  • Built in artificial intelligence - suggestive scheduling

MEMBER SESSIONS

  • Biomarker & HRA review
  • Member interests, concerns, goals
  • Chronic condition(s)
  • Medication(s) and alternatives
  • Care gaps and HEDIS guidelines for PCP referral
  • SMART goal setting

DURATION

  • Monthly sessions
  • 24/7 availability
  • 20-30 minutes each

CREDENTIALS

  • NDs, RNs, LPNs, Master-level Nutritionists
  • Certified in health coaching
  • Motivational Interviewing
  • Stages of Change - Transtheoretical Model
  • Average 5-years experience

Care Management: PRICING

Our Clinical Coaches are W-2 employees of Kadalyst. We never outsource or contract with 3rd parties. Employing our own in-house clinicians and health professionals that operate and interact as a “Care Team,” is what leads to our high levels of engagement and employee care support efforts

OUTREACH
25
Up to 25 eligible members
$1,375/mo
  • Analytics - $1.50 PEPM
OUTREACH
50
Up to 50 eligible members
$2,750/mo
  • Analytics - $1.25 PEPM
OUTREACH
75
Up to 75 eligible members
$4,125/mo
  • Analytics - $1.50 PEP1