Condition Care Management

The issue: In traditional managed behavioral healthcare and employee assistance programs, behavioral healthcare service delivery begins only after the member requests the need for assistance. Today’s models lack the tools that allow these programs to be pro-active in determining what member population may be at most risk and then providing them with the necessary advocacy to deal with difficult conditions. The re-active natures of today’s models has contributed to the rise in behavioral healthcare cost and lack of confidence by employers - both in the public and private sectors – and the offices of Medicaid, Medicare, and other such funding sources. Employers, Medicaid, Medicare, and additional funding agents are demanding business models that can identify members that may require behavioral healthcare services and guide them through a successful treatment program before their condition begins to deteriorate.

The solution: Today’s consumer-driven healthcare environment demands proactive, cost-effective patient outreach. InfoMC’s eCura solution uses clinical and claims (both medical and pharmaceutical) data to support proactive management of patient populations and to create measurable and cost-effective intervention programs. By placing the right technology in the hands of care coordinators, providers and members, your disease management program will increase compliance with your care guidelines for a more effective and efficient approach to disease management. eCura allows disease management organizations (DMOs) to identify members that may require behavioral healthcare services and guide them through a successful treatment program before their condition worsens.

eCura Works the Way DMOs Work

eCura can be adapted, re-configured, and tailored around your business. Through powerful search and tracking capabilities, eCura can retrieve members’ demographic history and eligibility information, offering you important data for predictions and assessments. You have easy access to complete and accurate information—including member benefits, coordination of services amongst providers, medical and pharmaceutical claims data, and clinical assessments.

eCura’s resilient database rises to the challenge of your dynamic requirements. “Point & click” technology with drop down menus and online help allows fast integration of eCura into your organization. It also has the ingenuity to streamline your workflow while providing the flexibility to support your unique procedures.

Most importantly for DMOs, the functional depth of eCura is adaptive and customizable. It helps you anticipate and adjust to procedural changes, ensuring seamless interaction with resources such as primary care physicians (PCPs) and ongoing management of your members. So when member data requirements change, new treatment methodologies or modalities are introduced, or referrals need to be monitored or modified, you can respond successfully.

• Identify members that belong to the appropriate care management program - depression, bi-polar, anxiety
• Load eligibility and enroll members electronically
• Track members medical and pharmacy claims data
• Support proactive and coordinated healthcare based on existing clinical data
• Integrate third party clinical criteria guidelines such as McKesson InterQual® clinical guidelines for comprehensive and evidence-based criteria sets
• Develop a structured and analytical approach to chronic care management
• Link clinical service authorization to claims payment
• Conduct effective case management using industry best practice assessment instruments
• Use automated work flow to manage your daily tasks
• Aid in identifying consumers who are overdue for needed tests and appointments
• Coordinate cases throughout all the levels of care provided by your network
• Give network providers the tools they need to better serve patients and foster a sustainable healthcare infrastructure.
• Exchange information between providers online in real-time via the internet

With eCura, the goal is to help you deliver the exceptional services your members require all while eliminating inefficient expenses for your business.

Extending the power of eCura

eCura is your path to becoming a successful disease management organization. It starts with connecting all stakeholders via the internet and integrating services between primary care and behavioral healthcare. eCura streamlines healthcare communications among consumers, providers, and payors with secure messaging, disease management, and claims management technologies. By integrating these solutions, eCura enables disease management content to be presented where and when it is needed. Coordinating information and services are the keys to a comprehensive disease management program. Having a solution that can anticipate behavior patterns and guide the clinical team using work flow automation, takes the guess work out and puts practical sense back into care coordination. eCura also allows your members to check a breadth of rich content relating to health and wellness information and score on several self-help assessment instruments on-line.