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Flexible Enterprise Solutions for Diverse Markets

 

Casenet solutions are designed to be flexible enough to serve the different needs of our diverse client base. Casenet also supports on a large scale some of the highest acuity patients in the industry. As a result, Casenet has a deep understanding of how managed care and other organizations manage commercial, high touch as well as high-risk patients which enables the Casenet team to develop and evolve our platform to meet the changing needs of our clients.

 

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Casenet Overview

Evolution of Care Management whitepaper

Dual Eligible Patients whitepaper

 

TruCare

 

Commercial

Medicaid

Medicare and ACOs

Carveouts and Other

Risk-Bearing Entities

Third party administrators (TPAs) and other health plans with commercial lines of business have complex organizational and care management needs. They must be nimble in order to adapt to changing market, employer group and regulatory requirements. Casenet’s flexible and scalable enterprise care management platform offers unique capabilities designed specifically for commercial health plans and TPAs including:

 

  • Flexible configuration of plan programs and requirements by many different factors such as line of business, employer, division and product. Learn more
  • Scalable architecture to meet line of business and employer needs. Casenet’s current largest production customer currently supports many lines of business, thousands of concurrent users and millions of members on a single instance of TruCare. Learn more
  • Extensive interoperability capabilities to ensure connectivity with clinical, financial, administrative or other required systems. Learn more
  • Adaptable portal solutions for both members and providers which enable improved communication, collaboration and coordination. Portals also enable wellness and disease management options. Learn more

Medicaid is the nation’s main public health insurance program for people with low incomes and the single largest source of health coverage in the United States. Medicaid covers over 66 million Americans and is the main source of coverage and financing for nursing home and community-based long-term care.

 

The unprecedented transformation and experimentation now underway in Medicaid provides an opportunity to identify robust access to person-centered and coordinated care and alignment of financial incentives with performance goals, all of which can benefit Medicaid programs and the millions of people they serve.

 

Casenet serves millions of high-risk and high-acuity Medicaid members today and is uniquely qualified to provide Medicaid care management solutions for health plans and other risk bearing entities. Casenet's current largest production Medicaid client presently supports multiple locations, thousands of concurrent users and millions of high-acuity members on a single instance of TruCare. Learn more about TruCare and its comprehensive capabilities for managing Medicaid members including:

 

  • Flexible segmentation of populations by many different factors such as line of business, state, region, population, and program. Learn more
  • Extensive interoperability capabilities deliver a single unified view of member information by seamlessly connecting clinical, financial, administrative or other systems. Learn more
  • Adaptable portal solutions for both members and providers which enable improved communication, collaboration and coordination. Portals also enable wellness and disease management options. Learn more
  • Home and community-based services enable the coordination of clinical and non-clinical services for long-term care and state and federal waiver programs. Learn more
  • Mobile solutions enable field-based care teams to deliver the services needed regardless of member location or living preference. Learn more

Medicare provides health coverage to 47 million people — including 39 million people age 65 and older and another 8 million younger adults with permanent disabilities. Medicare covers a population with diverse needs and circumstances. While many beneficiaries enjoy good health, nearly half live with three or more chronic conditions and more than a quarter have cognitive impairments.

 

Looking ahead, Medicare spending is projected to increase by two-thirds from $512 billion in 2014 to $858 billion in 2024—an average annual growth rate of 5.3% in the aggregate—due to growth in the Medicare population and increases in healthcare costs.

 

In addition to managed care organizations, Accountable Care Organizations (ACOs) also provide care for Medicare beneficiaries with a focus on coordination of care, decreasing duplicate services and the sharing of patient information across all the disparate systems in an ACO.

 

Casenet delivers a unique set of care management capabilities that help managed care organizations and ACOs manage the diverse needs and circumstances of Medicare members including:

 

  • Flexible segmentation of populations by many different factors such as line of business, plan, region, population, and program. Learn more
  • Extensive interoperability capabilities deliver a single unified view of member information by seamlessly connecting clinical, financial, administrative or other systems. Learn more
  • Adaptable portal solutions for both members and providers which enable improved communication, collaboration and coordination. Portals also enable wellness and disease management options. Learn more
  • Mobile solutions enable field-based care teams to assess members and coordinate the services required for smooth transitions of care regardless of member location or living preference. Learn more

To meet the needs of carveouts and other risk-bearing entities, Casenet offers a combination of specific capabilities and unique modules. These include interoperability options, home and community-based services and mobile capabilities. Learn more.