TruCare is an enterprise care management platform that enables you to effectively manage your members to improve care and lower costs. Care teams access a single, integrated care plan while each user has their own tasks and assignments built into the workflow. Care managers design and deploy personalized care management programs and new member data is continually added giving users an up-to-date view of each member’s health. Users efficiently manage utilization including appeals and grievances, authorizations, procedure requests,concurrent reviews, discharge planning, care coordination and more.
Segment your member population and consistently deliver tailored care management and utilization management programs to each population. Populations can vary by different factors such as line of business, state, region, program, client or your own unique definition. You can target specific interventions for each population and automatically execute workflows, rules and policies according to your segmentation.
Access a 360-degree longitudinal view of each member, identify gaps in care, and implement interventions. Care teams can facilitate preventative care so healthy members remain healthy and high-acuity members get the special attention they need.
TruCare is configured to your specific workflows to optimize efficiency and reflect your policies. Enable rules-based automation and establish guidelines to ensure care teams know what they need to do and when they need to do it to ensure members receive the most appropriate care.
TruCare Connect, powered by Health Trio, is a population health portal that makes it easy for patients, providers and caregivers to communicate and share information with health plans and care managers in a secure environment.
Members view benefit information, update demographic information, view the status of authorizations, and update their primary care physician.
Patients, providers, and caregivers exchange real-time messages securely, view care plans, and check the status of referrals and authorizations.
One source of truth
TruCare Connect is your single source of truth. Users communicate securely, share files, and receive alerts. Role-based security and features create a personalized experience for each user.
TruCare Analytics is a joint effort between Casenet and top data analytics partners, including HBI Solutions, that gives you the analytics you need to identify gaps in care, stratify members, understand populations at risk and take action. By stratifying your members, you can improve overall population health.
Proactively identify high-acuity members and enroll them in care management programs to prevent adverse events, unnecessary utilization and high costs.
Predictive risk analysis
Embed predictive modelling into the care management process to identify members who are likely to become high-acuity patients in the future and trigger prevention programs.
Tracking and Trending
Report outcomes and share results, including the percentage enrolled in care management programs, decreases in utilization, and costs associated with care management interventions.
Care managers turn to TruCare GuidedCare, informed by MCG Disease Management, to develop assessments and care plans based on the most current clinical evidence.
Evidence-based Clinical Assessments & Care Plans
Assessments with branching logic trigger educational handouts and relevant care plan elements like problems, goals, interventions, and barriers to enable care managers to create a personalized plan of care for each member.
Improved care team efficiency
Care managers use integrated tools to build evidence-based assessments and care plans quickly and easily; these assessments and plans drive automated tasks that are built into the care management workflow.
Complete member care and education
Care managers are guided through a series of considerations when assessing a member including, hereditary, socio-economic, physical, behavioral and environmental risk factors. This enables care managers to provide members with education and self-care advice based on their particular health status.
TruCare Linx, powered by HealthLX, translates data from electronic health records, health information exchanges, and other clinical systems using HL7 industry standard formats. Care managers can see when patients are admitted to a hospital, transferred to another facility, or discharged from the hospital using Admission, Discharge, Transfer (ADT) notifications. They can also view Continuity of Care Documents (CCD) to ensure they have a summary of the member’s clinical information.
Casenet is a founding member of the Da Vinci project, an initiative that is leveraging HL7 FHIR to improve data sharing in value based care arrangements.
Real-time data connectivity
Care teams see care events in real time so they know the member’s location and can respond proactively to better manage transitions in care.
TruCare Linx provides instant access to information about important health events, even when the data lives in disparate systems. This allows care teams to access a holistic, real-time view to make informed decisions about next steps.
Data standard compliance
TruCare Linx uses HL7 standard industry formats, which means care managers receive ADT alerts and CCD documents no matter what EHR, HIE, or clinical system the data resides in.
TruCare ProAuth makes it easy for users to submit authorizations and receive real-time determination responses and status updates.
Providers enter minimal information to confirm if an authorization is required. When authorizations aren’t required, or if a duplicate authorization exists, TruCare ProAuth lets providers know instantly. If an authorization is required, TruCare ProAuth prepopulates fields to make data entry efficient. Health plans can implement a rules-based configuration to prompt providers to include specific clinical information to expedite decision making.
We configure TruCare ProAuth based on your business rules. You decide which authorizations require clinical reviews and which don’t. Authorizations can be automatically approved based on your rules about providers, diagnoses, procedures, services, service thresholds, and other information in the authorization request.
TruCare Reporting provides robust standard and ad hoc reporting and dashboard capabilities from the Jaspersoft reporting module. TruCare Reporting offers sample reports including, user activity, metrics monitoring, audit trails and compliance reports. Reports can be scheduled and automatically distributed, and access can be restricted based on permissions.
TruCare Reporting is designed for non-technical users, which makes it easy to use. Care managers and supervisors build and run their own reports using drag and drop field functionality.
Powerful data analysis
Technical users create detailed and comprehensive reports that allow for deep analysis. Users design report templates; build report queries; write complex expressions; and layout components such as charts, maps, tables, crosstabs, and custom visualizations.
With the TruCare Mobile iPad App, care managers collaborate and manage patients anywhere at any time. Care managers efficiently assess their members in the field and securely access clinical, care management and member information.
Information at your fingertips
Care managers quickly access a subset of data while working in the field. Users can view and update demographic information, assessments, member summaries, allergies, diagnoses, medications, and notes. Authorization information, including the requesting provider, the dates the member was admitted and discharged, and the status of the authorization, can also be accessed.
Offline capabilities make it easy for care managers to manage care and have meaningful interactions with members, even when internet access isn’t available. When your care managers make changes to the member record offline, they are reflected once the user is back online.