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TruCare Actions Drives Population Health Management Efforts

 

TruCare Actions is a population health management tool that includes a highly configurable rules engine for segmenting members and initiating outreach. TruCare Actions uses claims, medical management and even 3rd-party predictive risk modeling data to enable organizations to define specific parameters for identifying targeted populations, at-risk members and gaps in care and then automatically triggering events, workflows and tasks for intervention in support of population health management initiatives.

 

TruCare Actions can be used for complex data-driven identification of high risk members. TruCare Actions provides the ability to stratify members based on the member's diagnosis and other parameters such as claims history, authorizations and case history. TruCare Actions enables the identification of gaps in care and opportunity management by using both data analysis and real-time event or action generation capabilities. TruCare Actions identifies and initiates key actions to be taken based upon clinical rules determined by the care team.

 

TruCare Actions parameters are fully configurable and provide client-defined, automated workflow capabilities which can utilize risk score information to trigger care management activities, such as creation of tasks, cases and letter generation. As a result, TruCare Actions can assign tasks for not only care team members but also for individual members and providers resulting in better health management and ultimately better population health.

 

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Casenet Overview

 

TruCare

Population Health Management

TruCare Actions Features

TruCare Actions Benefits

Because TruCare Actions provides seamless integration between Utilization Management and other Care/Disease Management programs, client-defined rules can be configured to identify targeted member populations for CM/DM program outreach or correspondence and for UM follow-up activity, such as post-acute care. TruCare Actions enables the configuration of event- or population-based rules, the ability to analyze data from multiple sources such as member, claims and third-party data and the identification of high risk members and member cohorts. Additionally, TruCare Actions can create tasks and correspondence for members with gaps in care and wellness opportunities as well as support members with chronic conditions.

TruCare Actions enables better management of population health by:

 

  • Identifying high risk members, gaps in care and wellness opportunities
  • Producing actionable output in TruCare such as
    • Letters
    • Cases
    • Messages to User
    • Tasks
  • Enabling immediate action on identified members or cohorts