Case Management for Payors
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KePRO Case Management improves the health of your employees, while decreasing costs
associated with episodic health events, hospital admissions and re-admissions, and
the unnecessary use of emergency departments, medical services, and equipment. Our
RN case managers work with your employees, their health care providers and families
or caregivers, other vendors, and available community resources.
Case management is necessary when your population has:
- Acute health care needs, diagnoses, or hospitalizations
- Complex medical issues and co-morbidities
- Complex hospital discharge requirements
- Complex social issues.
We target eligible participants at greatest risk for high cost, short term and long
term medical claims. Our program is voluntary, so your employees must consent to
participate. Employees agreeing to participate work with RN case managers to
make appropriate self-directed care choices, become better advocates, and make more
informed health care decisions.
We have several case management options available:
- Episodic
- Complex
- Care coordination.
Episodic case management targets employees who require short term
coordination of services and support beyond discharge from acute care, rehabilitation,
or skilled nursing facilities. We engage employees and their families and physicians
to facilitate post discharge follow up and coordinate care management needs while
they are still in the hospital. We help prevent readmissions and increase compliance
with physician treatment plans.
Complex case management targets the most costly
one to two percent of your population. We provide more long term, high intensity
support for high risk and at-risk individuals. We help your employees get the appropriate
care and manage their conditions or illnesses. Better self-management improves overall
quality of life and reduces your care costs.
Care coordination does not require consent and allows us to proactively
manage your employees who need short or long term coordination of services. Our
RN case managers work with each employee’s care team to coordinate health needs.
This results in early, proactive management of your population and increased savings
for you.
Optional Services
We also offer optional buy-up services:
- Onsite Assessments
- 24/7 Nurse Advice Line & Coverage.
Call 1.800.222.0771 to put KePRO Case Management to work for you! Or contact
our business development professionals directly.