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Small payers leverage IT

Small payers leverage IT

December 31, 2008 | Patty Enrado, Special Projects Editor

Related Links

  • MEDecision press release
  • DC Chartered Health Plan
  • HCSC completes merger with MEDecision

WASHINGTON – DC Chartered Health Plan has begun implementing MEDecision’s care management technology to service its growing Medicaid population.

With co-morbidities of DC Chartered’s members stretching its clinical capabilities, the Alineo Collaborative Health Care Management platform will enable the private managed care company to better manage its 80,000 members, said CEO Karen Dale.

The platform will turn paper-based processes into electronic ones.

“There are a lot of efficiencies we’re hoping to gain in a streamlined operation,” Dale said. “The outcomes are not changing, but we have to do more with less.”

Alineo’s disease management piece will enable DC Chartered to plug members to the appropriate disease management program. The care management piece will integrate components of care and allow care managers to document and view in one place.

“Every contact with members needs to be maximized,” Dale said.

Alineo provides a cost-effective solution to support small health plans that have very little room for financial error, said David St. Clair, CEO and founder of MEDecision.

This implementation reinforces the need to invest in managed care areas, he said. The clinical criteria, programs and best practices available today are not fully developed for the Medicaid population.

Adding to the burden of state Medicaid programs’ complex requirements is the anticipated jump in eligible enrollees as more people lose their jobs, said Lynne Dunbrack, program director, Health Industry Insights.

Related Topics:
  • January 2009
  • MEDecision
  • Washington

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