Through coordinated and comprehensive care, we help to reduce costs, reduce patient health risks, and improve outcomes.
ConcertoCare uses in-home care teams to provide clinical services in support of plans' existing network providers, creating a value add for PCPs and health systems, while coordinating patient care. We work with providers, specialists, patients, and health plans to support a complete approach to health care.
We close gaps through whole-person care – ensuring each encounter with a member is optimized to drive comprehensive patient management.
Assessment and diagnosis – Comprehensive and clinically validated assessments ensure appropriate evaluation and management of patient diagnoses.
Treatment plans – Patient-centric care plans are developed and implemented in conjunction with providers and specialists.
Preventive care – Our care teams ensure members receive appropriate preventive care, resulting in HEDIS gaps closure.
Risk optimization – Risk adjustment results from thorough patient evaluation and compliant documentation and coding of disease burden.
Tailored disease pathways – Disease pathways build on custom patient treatment plans to ensure disease specific treatment goals are met.
Quality measures – Gap closure measures include medication adherence, reconciliation, advanced care planning, fall risk, evaluation, and management, etc.
ConcertoCare uses an end-to-end model designed to optimize value. We combine multiple data sources (medical claims, prescription drug claims, eligibility, third-party data) to develop a holistic view of each patient. Members enrolled in our program achieve lower costs, fewer inpatient hospitalizations, and fewer ER visits than those not enrolled.
Plan savings resulting from MLR improvement can be reinvested to significantly enhance member benefits or reduce member premiums.