Helping health plans improve health and reduce costs for Medicaid and Medicare members
In every population healthcare costs are typically driven by a relatively small percentage of individuals. This is magnified in Medicaid populations where multiple co-morbid conditions, serious mental illness and complex social needs exist, and services are fragmented among multiple providers and payers.
Inappropriate emergency room use, unnecessary inpatient stays, hospital readmissions within 30 days, discharge planning, and medication adherence are all significant factors influencing the cost of care and outcomes. With as much as 50% of ER visits being avoidable and 10% of inpatient stays for Ambulatory Sensitive Conditions, utilization and quality can be dramatically improved through coordinated patient care and targeted interventions.
A leader in complex care coordination for Medicaid populations, APS Healthcare has demonstrated expertise in identifying high-risk, high-cost and uncoordinated care opportunities - improving quality, reducing cost and increasing access to evidence-based care.
Our services focus on Complex Care Coordination, including:
- Disease Management & Case Management
- Palliative Care Management
- Specialized Programs for SMI
- Medication Adherence
- Behavioral Healthcare
- Utilization Management
