Care Management Toolkit

NOTE: You must login to your Alliance account to access the articles and resources below. Some content may only be accessible to Alliance members.



Whitepaper: Appropriateness of Care Measurement
Motive Medical Intelligence shares insight on reducing waste and improving outcomes through evidence-based clinical best practices.


Recording: Care Management Engagement Strategies: Addressing Unable to Reach Members
Alliant Health Plans kicks off the conversation about care management engagement by sharing current challenges and an exploration of strategies to improve effectiveness. Attendees discuss best practices, working with interdisciplinary groups, and dealing with the hard-to-reach members.


Presentation: Care Management - Reaching Members
Alliant Health Plans kicks off the conversation about care management engagement by sharing current challenges and an exploration of strategies to improve effectiveness. Attendees discuss best practices, working with interdisciplinary groups, and dealing with the hard-to-reach members.


Care Coordination Metrics
Health Alliance Medical Plans shares the metrics they use to track their care coordination programs.


Presentation: Case study - A medical home program powered by data
SelectHealth shares how they are incorporating pay-for-performance programs, provider engagement and chronic condition management approaches to support HCCs and quality gap in care closure. Presented at the Leveraging Analytics meeting in Fort Worth, Texas.


Presentation: What leveraging pop health, big data and social determinants looks like in the real world
Carrot Health discusses how Alliance participants are using SDoH to impact Medicare Star ratings, care management and risk adjustment. This presentation took place on January 31, 2019 during the Leveraging Analytics meeting in Fort Worth, Texas.


WEA Trust: Addressing Member Access Issues Through Urgent Care & Behavioral Health Telehealth
American Well's Jasmine Rogness, product management specialist at WEA Trust, discusses how WEA Trust addressed. their issues through telehealth.


Templates: Medical Management Dashboards
Health Alliance Plan shares templates of medical management dashbaords for a variety of audeinces. Included are dashboards for Executves, Management, and the Frontline. Contains dummy data.


Presentation: Automating Prior Authorization: Removing Barriers to Utilization Management
In this webinar, eviCore shares how health plans can continue to benefit from utilization management programs while preserving provider relations and growing networks.


December 2018 Coding Work Group Case Studies
Geisinger Health Plan shares recently coded charts and questions to facilitate discussion on risk adjustment coding best practices during the December 6, 2018 Coding Work Group Session.


Building Payer-Provider Partnerships for Care Management
In this white paper, Navigant Consulting Inc. and the Health Plan Alliance share eight strategies for success in care management. Based on research among three leading provider-sponsored health plans (Health Plan Alliance members), the paper provides real-world examples of how payers and providers can collaborate successfully in developing care management strategies and reducing per member per month costs.


Meal Delivery Programs Reduce The Use Of Costly Health Care In Dually Eligible Medicare And Medicaid Beneficiaries
Delivering food to nutritionally vulnerable patients is important for addressing these patients social determinants of health.


Presentation: Population Health and Care Management for Complex Patients
Adventist Health Plan shares how they used traditional population health approaches,complemented by a complex care management clinic and team of health care professionals, to manage a rural population of families, adults, and seniors and persons with disabilities (SPDs) to meet their health care and social needs in a quality, cost efficient manner.


Care Management Satisfaction Survey
Network Health Plan provides an example of a care management satisfaction survey.


Presentation: How to achieve a 10:1 ROI on care management programs AND reduce disenrollment and close gaps in care
Welltok will share how they support and drive value for Health Plan Alliance (HPA) members. They will also share how there award-winning consumer activation platform, advanced analytics and multi-channel communications help health plans increase member retention and satisfaction, drive engagement and improves healthcare value.


Presentation: Exploring the Information Gap and Solutions
Change Healthcare consultants identify common problems and scenarios facing health plans and providers and discuss technology and solutions for developing encompassing data-sharing capabilities with the goal of improving health by engaging patients and communities. This presentation took place June, 2018 during the Health System/Health Plan Value Visit in Chicago.


Numerof: The State of Population Health
Numerof & Associates teamed with Dr. David Nash, Dean of Jefferson College of Population Health, to study the evolution of population health management. Report is based on a survey of 400+ C-suite healthcare executives.


White Paper: 10 Reasons to Outsource Your Health Risk Assessment
The Health Risk Assessment (HRA) is a critical tool for population health management, developing wellness interventions, and encouraging lifestyle changes to control healthcare costs. It's a valuable resource to help you tap into data to measure the health of your population, risks for chronic disease, and the outcomes of your wellness initiatives.


Presentation: Medicare Diabetes Prevention Program Follow Up Roundtable Discussion
Joe Ledbetter and Elizabeth Goff of IU Health Plans will provide an update on the status of their discussions with their Indianapolis YMCA and Natasha Goburdhun, VP of Business Development and Operations with the YMCA of the USA Managed Services Organization (MSO) will also share an overview of their organization and how they are working with YMCA's across the county who provide DPP services.


Presentation: Beyond DM: A Population Health Evolution
Representatives from Avera/DAKOTACARE share an overview of their organization's evolution from outsourcing case management and disease management programs to in-house programming to now merging the medical management teams from two separate health plans.