ENCOMPASS Chronic Care Management
ENCOMPASS Chronic Care Management assists people with multiple medical conditions who are experiencing limitations to activities, deteriorating health and high utilization of medical services. ENCOMPASS' highly qualified nurse case managers work to identify and address the individual care needs of these people through:
- Creating individualized/customized treatment plan
- Impacting conditions and prioritizing factors
- Promoting member education and health improvement through health coach approach
- Collaborating with providers and appropriate family members
Customizing Solutions
ENCOMPASS works with clients to review claims experience and designs a program based on this knowledge. A typical ENCOMPASS Chronic Care Management program identifies participants with:
- An excess of $25,000 in annual paid claims
- A primary condition and multiple affecting conditions contributing to continued health deterioration
These members often represent only 2 to 4 percent of the total covered population but 40 to 60 percent of total health plan costs.
Chronic Care Management is one of the full range of ENCOMPASS Health Management services offered. We work with each client's health plan requirements to build a customized profile from our comprehensive Care Coordination and Medical Management solutions.
As with all ENCOMPASS services, Chronic Care Management case information is completely integrated in our proprietary software system, QualiTrac, which supports documentation and reporting for all programs. QualiTrac is a member-centric system making information available to ENCOMPASS medical professionals to address health status and medical needs across all Care Coordination and Medical Management programs.
Improving Outcomes
For more than 20 years, our commitment to supporting the right care at the right time in the right setting has created successful partnerships with members, clients and health care providers. Because we work to improve the quality of medical care received as well as eliminate unnecessary treatment, health care costs generally decrease due to improved outcomes.
Demonstrating Results
ENCOMPASS' Chronic Care Management program value is demonstrated through report packages documenting improved health outcomes, health care savings and return on investment. All reports are specific to the individual client. Additionally, major reports provide health plan cost comparison over consecutive plan years.