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The Client

Advanced Plan for Health (APH) utilizes a combination of skill, “art” and data analytics to create a customized Nurse Care Navigator (NCN) program that best suits each self-insured employer and its health plan members. In minutes, our NCN can view the overall trends and take a deep dive into targeted and high risk individuals and trends to find the care gaps, formulate a strategy, network to take the best approach and measure the process and outcomes to ensure success. 

The Challenge

Each employer’s history, geographic dispersion, work environment(s) and health cultures differ

 

The program needs to be engaging, satisfying to participants and able to address “root causes” to truly achieve health and performance improvement

 

The ability to track trends is critical to effectively allocating resources and directing the rightresource and approach to get the optimal result in collaboration with the health team

 

    APH Action Plan


    → Review plan trends to stabilize costs and get the full benefit of expenditures in time, resources
    and talents


    → Organize the population according to level of risk and design interventions designed to optimize member health and productivity across the care continuum from prevention/health promotion to chronic health conditions/behaviors and onto to individuals with high risk/utilization


    → Survey and enhance the “local advantage” and provide data analytics to strengthen medical homes and other interdisciplinary efforts that optimize effective utilization for both the medical and pharmacy plans


    Success  

     

    One client, an employer with a geographically diverse employee base, now has the advantage of telephonic medical management combined with local NCN’s who know community and system resources. This program has produced great results, specifically a reduction in medical PMPM from $246.98 to $231.32 over the past three years.

     


    *A life saved: One nurse care navigator detected a positive tobacco test, which was due to a carbon monoxide leak at the employee’s home. Early detection and quick action lead to preemptive measures that helped save the lives of the employee and their family.

     

    “Advanced Plan for Health has been a trusted partner for many years helping us identify risk and manage that risk in various ways. Their analytics, support and involvement have been instrumental in our success. They are a resource as well as an advocate for improved health of our employees.”

    Carolyn Ehlers, Benefits Manager