Collaborative Care Management
In today’s healthcare delivery environment, the complexity of managing members’ health conditions and outcomes is increasing as providers and health plans strive to improve the quality of care while containing costs. When different processes and systems limit this collaboration, adverse affects on care planning and coordination occur. Continuity of care calls for close collaboration and information sharing among all stakeholders to improve outcomes and more effectively manage costs.
Designed by clinicians, HP’s Atlantes Care Management solution allows commercial and government payers to deliver comprehensive collaborative care management. The Atlantes web and mobile enabled solution addresses the work flow needs of population health management across diverse programs. These range from wellness and lifestyle management to chronic condition and disease management to home and community based services. Its flexibility can provide value at every point in the continuum of care.
Atlantes facilitates true coordinated care and informed interactions by providing a comprehensive view of the member across the healthcare delivery system. It helps stakeholders more efficiently utilize the available funds by automating and streamlining the delivery of care process. This supports a more collaborative care model for members whose health conditions are at-risk, members with various acute and chronic conditions and offers support for members eligible to receive home and community based services.
Atlantes is scalable and easily integrated with legacy applications. It's also available as a shared service— our modular components include work flow solutions that support Case and Disease Management, Referral Management, Healthy Lifestyle Management and others.
Clients can extend the use and value of Atlantes through inclusion of HP’s solutions and services including Member and Provider web portals, as well as with Medical Informatics and Population Risk analytics.
The Atlantes Care Management application collectively manages information from multiple care management programs, providers and other data sources into a single longitudinal member-centric database, all from a single sign-in with one-click navigation. It is designed for flexibility and adaptability to meet an organization’s specific needs.
Because Atlantes is a comprehensive and configurable care management solution, an unlimited number of care management activities on a member can be active at the same time; allowing for integrated management by multiple care delivery stakeholders. Additionally, Atlantes automates many of what are traditionally manual care management functions such as:
- Individual response-based triggering of additional condition assessments
- Individualized care plans including, goals, objectives and interventions
- Auto-triggering of member informational and educational mailings
- Scheduler functions to assist the care manager in planning and organization
These modules allow health plans to configure health risk assessments and surveys, care plans, correspondence and educational materials and reference data. Opportunities to assess, intervene and set goals are identified with the objectives of reducing costs and providing optimal care by moving members to the appropriate level of care.
Costs related to members with one or more chronic conditions account for over 70 percent of U.S. healthcare costs. A focused chronic care management approach avoids costly acute episodes of care and controls utilization to avoid unnecessary expenditures.
Atlantes Case and Disease Management (CM/DM) module provides focus on key care management practices:
- Prospectively targets high cost, catastrophic cases and high users
- Leverages data from disparate sources to identify gaps in care
- Identifies opportunities for intervention (problem list) and goal setting while reducing costs by moving patients to the appropriate level of care
Federal and state efforts have focused on increasing the control individuals and families have over the home and community-based services (HCBS) they receive. Programs are typically implemented as plan member options as alternative care settings to long-term care institutions. These initiatives enjoy widespread support because they give greater control to individuals and their families and often result in lower cost and greater quality of life.
Atlantes HCBS functionality includes the ability to track cases, develop and manage level of care plans, schedule and monitor compliance to Plan-specified events. It also offers incident tracking, expanded member demographics, provider and transition coordinator information related to specific target populations.
HCBS capabilities combined with Atlantes comprehensive case and utilization management components deliver a best in class solution to support state and local and managed care organizations home and community based services.
Atlantes facilitates health advocacy through true coordinated care and informed one-to-one interaction by providing a single point of view of patient information across the system. It assists care managers and health coaches in encouraging members to become more aware of their disease, condition, or other healthcare needs while providing them the tools they need to educate and motivate members to take control of their own healthcare.
Integrated programs can be designed to address specific target populations, such as members interested in heart disease prevention or diabetes prevention. Atlantes also provides clinical content to support member risk management.
HCBS capabilities combined with Atlantes comprehensive case and utilization management components delivers a best in class solution to support state and local and managed care organizations home and community based services. Atlantes wellness management programs include health education modules and risk intervention programs that support member lifestyle improvement, maintenance of overall health and illness prevention. Based on Health Risk Assessment responses, Atlantes will help members and their health coaches develop a wellness plan.
Atlantes Utilization Management (UM) is designed for the traditional functions of concurrent, prospective, and retrospective reviews. Our UM functions help guide members through a sometimes intimidating healthcare system. The care manager is assisted in determining the most appropriate and cost-effective treatment options, with the application helping to resolve disagreements and determining best options. The module offers precertification, prior authorization adjudication and discharge planning, inpatient stay information and more.
The UM module meets multiple accreditation standards and incorporates such user-defined and third party care guidelines. Utilization costs are reduced through the use of integrated clinical criteria and guidelines and cost savings tracked and reported. It offers a simplified work flow that provides the user with the ability to record all information pertaining to the review process, as well as view related information, integrated from multiple sources.