CareCentrix

Member Level: Vendor

Vendor Overview

Description of Services: CareCentrix has been managing post-acute solutions for over 20 years, working with payers and providers to create programs that improve quality and lower costs by allowing members to age and heal where they want to be: at home. We have extensive experience managing post-acute care for Medicare, Medicaid and Commercial members. We currently manage more than 25 million members nationally, including 1M Medicare and 500,000 Medicaid members. Our post-acute care offering utilizes a multi-disciplinary clinical team of over 300 clinicians, led by a geriatrician with extensive experience in post-acute care. Our program works collaboratively with hospitals and post-acute providers across the nation, and provides in-market, clinical staff in key post-acute management markets. We have presence in most markets today, where we coordinate post-acute services for members for DME, home health, and home infusion, with additional support for SNF/IRF/LTAC in certain markets.

We have developed a unique and integrated approach to Post-Acute Care (PAC) that is patient-focused with the goal of sending the patient home as soon as it is safe and clinically appropriate. This integrated approach fills the gaps between fragmented services by identifying the best path for the patient’s care, engaging the highest-performing providers, and intervening for patients most at-risk for readmissions. Whether CareCentrix manages the entire continuum of post-acute care or integrates programs to manage areas of specific need to compliment in-house programs, our health plan partners have saved millions of dollars while improving outcomes.

Issues:
• Post-acute care accounts for an estimated 20-25% percent of total spend in Medicare Advantage plans.
• Payers absorb $17.5 billion in wasteful spending while patients face unnecessary medical risks and costs.
• 75% of hospital readmissions are caused by preventable errors.

CareCentrix solutions:
• POST-ACUTE CARE (PAC): Reduce costs by optimizing provider networks, improving care transitions, and avoiding readmissions.
• HOME HEALTH & HOME DME: Streamline Home Health & Home DME management through a high-performing, fully credentialed national network.
• HOME INFUSION: Address the growing cost and complexity of infusion therapy and allow more patients to get treatment at home.
• HOME SLEEP: Manage the costs associated with sleep testing and sleep therapies by guiding care to the home.

Value we provide:
• In-depth expertise: CareCentrix has served 25+ million members over 20 years in the healthcare arena
• Reduction of overall costs: Our services have helped reduce PAC costs for our client’s by an average of 15%, saving our clients over $400 Million dollars annually……
• Diminish hospital readmissions: We have helped health plans reduce readmissions by 40% (our readmissions window is 90 days)
• Happier Patients: 95% of patients would recommend the CareCentrix program to a friend
• Guaranteed Savings: In general, our pricing is full-risk through either capitation or administrative fees with shared savings and return on investment guarantees.

We have a very flexible platform that can be designed to fit within your existing processes, increasing value and helping you to maximize the resources you currently have in place.

Primary Service: Utilization/Care/Disease Management
Secondary Service: Enterprise Data

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HARTFORD, CT: 20 Church Street, 12th Floor Hartford
Hartford, CT 06103
1-888-839-5122
https://www.carecentrix.com

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