Integrated Care Management

Organizational Realignment: Create a Care Management Environment that Maximizes Client and Program Success

Cartesian Solutions, Inc.™ helps employers, government agencies, health plans, care delivery systems, and care management vendors customize workplace environments designed to reverse and/or stabilize health and reduce total health service use and cost for some of their most difficult to treat and expensive constituents. Cartesian Solutions, Inc.™ considers implementation of ICM procedures "low hanging fruit" with great potential for a clients' return on investment if ICM management principles are included as critical outcome changing components in existing workflows. Organizational realignment support from Cartesian Solutions, Inc.™ is designed to assist clients incorporate these critical components and also to help them avoid expensive mistakes as they upgrade to an integrated approach to complexity management.

If your care management program faces the following challenges...

• Value to company/system: poorly understood; unaligned
• Management triggers: inconsistent/inappropriate
• Case manager work processes: variable; based on background (medical or mental health) and clinical intuition
• Endpoints/objectives: poorly defined; bring limited value
• Caseloads: guesstimates (too high; too low)
• Outcome measurement: process-based rather than measures of actual improvement; inadequate measurement of
• Clinical, functional, and cost outcomes
• Program, clinic, manager performance
• Orientation and procedures: segregated physical and mental health; siloed
• Training: limited systematic manager education
• Resourcing: poor support for value-based management services

...Ways that Cartesian Solutions, Inc.™ can help

• Value to company/system: provides interdivisional work process alignment that allows mission driven goal attainment
• Management triggers: incorporates systematic resource conserving identification of the most complex members—top 2% to 5%
• Case manager work processes: systematizes uniform interdisciplinary multi-domain assessments and connects disaggregated barriers to improvement to care plan development
• Endpoints/objectives: targets reversal of complexity-based barriers to clinical improvement with reduced health care service use and improved productivity
• Caseloads: institutes rules for ICM-CAG complexity-based estimation (promotes improved outcomes; decreases wasted time)
• Outcome measurement: initiates proactive barrier identification and documentation of progress
• Clinical, functional, satisfaction, and quality of life outcomes
• Cost outcomes
• Case manager, clinic, and program performance
• Orientation & procedures: implements integrated physical and mental condition “entire member” care manager work processes; interdisciplinary culture shift support
• Training: establishes manager education in complexity measurement, care plan development, and movement to member graduation; trains enrollment and support staff in assistance to care managers; updates medical directors/physicians in treat to target care management support through intervention esclation
• Resourcing: orients funding for case manager hires using complexity-based caseload estimates and projected health enhancing/cost saving outcomes

Purchasers of care lower health-related cost from Cartesian Solutions, Inc.™ assistance through the implementation of support services for chronically ill and complex employees and enrollees that improve clinical outcomes and lower health service use. Health plans and care management vendors save money by consolidating the administration of medical and mental health management (administrative savings) and lowering claims costs. Importantly, they can differentiate themselves in the market and increase market share by implementing more effective management practices. Hospital and clinic systems experience greater profits by decreasing the number of patient outliers for whom inadequate reimbursement is received for the services delivered. They do this by improving clinical outcomes for patients, which lowers unnecessary service use.

For more information or to set up an appointment contact: Mary Kathol, Director of Project Implementation.

Cartesian Solutions, Inc.™
3004 Foxpoint Rd. - Burnsville, MN 55337
Phone: 952-426-1626 - Fax: 952-426-1200
E-mail: integration@cartesiansolutions.com

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