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Here are a few recent examples of how LifePlans has been able to help health and long-term care insurers realize better health and business outcomes.

Medicare Advantage Plan: Urgent Need for HRAs Met in 45 Days

In December of 2010, a Medicare Advantage Plan learned it was going to be assuming responsibility for the management of roughly 4,000 new elderly members from another health plan. These Medicare Advantage members needed to have a health risk assessment (HRA) performed very quickly so that the Plan could triage them to the proper medical management programs, target specific members for additional Hierarchical Condition Category (HCC) coding, and develop strategies to keep these new members healthy.

The challenge for the Plan was how to do this quickly and efficiently, so they called LifePlans.

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Medicare Advantage Special Needs Plan: Assuring Continuity of Service for New York City Elders

In August 2011, a Medicare Advantage Special Needs Plan faced a dilemma.

It was assuming responsibility for recertifying the care needs of an additional 1,200 low income elders who were receiving personal care services from the state, and it had to do so within a very short time frame and with complicated state-mandated forms.

Moreover, service recommendations had to be directly related to clinical need. Not just any “objective” evaluation of these individuals in their home would suffice. They couldn’t be performed by a service provider in whose interest it was to always certify an ongoing need for services.

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Find out how LifePlans can help you achieve better health and business outcomes.