AWARD WINNING HEALTH & HUMAN PERFORMANCE (Productivity) MANAGEMENT SPECIALISTS |
Employers
Goals: Reduce/control rate of trend, reduce healthcare costs. Improve health status, health and work performance of covered populations
• Needs Analysis
- Gap or Opportunity Analysis with strategic plan to achieve healthcare, business and financial goals
- Nominal Groups
- Population Health and Productivity Analysis (PHPA/PHPA+)
Zoe reviews healthcare, disability and pharmacy claims from a
one-to-three year time period (depending on the population size), with particular attention paid to the following areas to identify trends, cost drivers and opportunities to reduce costs. Health risk information can also contribute to the sensitivity of our model and the outcomes from our work. |
• Lifestyle related conditions
• Prevalent chronic conditions
• Complex chronic conditions
• Top 20 cases by dollar amount, and preliminary diagnosis
• Disability claims (occupational and non- occupational)
• Pharmacy claims
• Maternity claims
• Mental Health and related health care claims
• Somatic Conditions ("Worried Well")
• An audit of existing disease management and case management programs
• Projections for future diagnosis of prevalent high cost conditions. ("Walking Wounded") |
|
• Disease Management (DzM), Maternity Management, Wellness Program Design/Development, and/or Vendor Evaluation and Selection - RFP Development, Management, and Procurement
• Obesity Management through policy revision, appropriate compliance and behavior change programs
• Wellness Program design and implementation for sustaining programs
• Pay For Performance (P4P) healthcare reimbursement models/programs
• Incentive design(s) for optimal outcomes
• Disability management: non-occupational and/or occupational
• Consumer driven programs
• Problem/Puzzle Solver |
Physicians
• Clinical Integration
• Medical Home Models
• Favorable reimbursement models based on pay for outcomes
• Achieving quality targets |
DzM Providers/Vendors and Health Plans
Goals: Gain clients, retain clients, increase competitive position, meet or exceed healthcare, business, program and financial goals
• Disease Management (DzM)
• Program, Market, Business Development/Enhancement
• Gap or opportunity analysis to achieve business and/or program goals
• Training
• CEU/CME Clinician Training Workshops in Changing Behavior through appropriate patient communication using the Conviction/Confidence/4E Communication model. Based on Rollnick, Bandura, Prochaska, and other leading behavioral scientists and practitioners. It is easy to use during patient interviews by phone or in-person.
• Case and Disease Manager CEU training related to impact of Obesity and Weight on patient outcomes and how to better manage their patients for optimal care and outcomes |
• Obesity Management through policy revision and appropriate patient accountability models including use of behavior change programs/techniques
• Purchase or licensing of Intellectual Property for systems and programs managing patients related to disease management, obesity and weight management; and maternal and child health management. This includes but not limited to: use cases, systems of care, nursing care plans, patient self-care plans, content, assessments with corresponding logic, a system for managing obesity and overweight individuals, and so forth.
• Problem/Puzzle Solver
• Development of Disease Management and Health Management Programs
• Other
|
Guiding the way to optimal healthcare and financial outcomes for individuals and the organizations responsible for their care or outcomes;
resulting in cost savings, improved or optimal health status, human, and work performance. |
