ENCOMPASS Disease Management
ENCOMPASS Disease Management assists people with specific medical conditions for which education and self care are a primary focus. The program is designed to help improve the quality of health for participants, while combating costs associated with these diseases.
ENCOMPASS' highly qualified case managers work to address the care needs of people with:
- Asthma
- Chronic obstructive pulmonary disease
- Coronary artery disease/congestive heart failure
- Diabetes
Program participants are identified and stratified into low, moderate and high risk categories based on claims history and clinical assessments, with corresponding program interventions designed to match health care needs.
Customizing Solutions
ENCOMPASS works with clients to review claims data and program goals to design a Disease Management program based on this experience. Disease 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, Disease 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.
To help ensure our services conform to best practices in the industry, our Disease Management program is accredited by URAC, a respected accreditation organization.
Demonstrating Results
ENCOMPASS' Disease 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.