News

Title
Population Health Care Coordination
Population Health Program Tackles High Cost Claims and Gaps in Care
Nov 20

In support of our goals of providing quality healthcare solutions at affordable costs, edHEALTH launched an innovative population health program in the spring. Did you know that 50% of edHEALTH’s claims come from just 5% of the population? The KnovaSolutions® Clinical Prevention Service focuses on those who need the most help. KnovaSolutions’ clinical team focuses on the highest risk, highest cost employees and their families with a holistic approach to support their needs.

Privacy Protected

This program ensures privacy while using predictive modeling to identify those in need of support early in their care journey. Personal health data is secure; KnovaSolutions® doesn’t share it with member schools or edHEALTH. Additionally, they store all data consistent with Health Insurance Portability and Accountability Act of 1996 (HIPAA) privacy standards.

Potential Reduction in High Cost Claims

The program features a clinical staff that provides personalized care for high-risk, high-cost employees and covered dependents. Through phone and secure email, participants receive support for medical decisions. Information, education, and decision support helps decrease unnecessary costs and utilization.

12 Hours/Day Support Fills Gaps in Care

Patients often have questions after they leave healthcare appointments, but it’s frequently hard to reach doctors and nurses. With KnovaSolutions®, help is a phone call or email away from 8AM to 8PM. Common questions include:

  • “I don’t understand my diagnosis, can you help?”
  • “How are all of these drugs helping me?”
  • “I’m being treated for cancer and am worried about post treatment complications. Where can I get support?”
  • “My new medication is making me feel sick. What should I do?”
  • “What can I do to lose weight? My doctor isn’t being helpful.”
  • “My doctor recommends surgery for a possibly cancerous cyst. Where can I get a second opinion?”

Easy to Enroll 

Nine of our 20 member schools have enrolled in the program, or are in the process of enrolling. “KnovaSolutions® makes it easy for schools to enroll,” says edHEALTH Operations Manager Cindy Bartelson. “After a 30-minute kickoff call, KnovaSolutions® provides the school with a suggested email to send faculty and staff. From there, KnovaSolutions® does the rest.”

No Cost for Member Schools

As announced at our Annual Meeting, there’s no cost to our member schools through at least 2020 for enrolling in the program. Additionally, participating schools will receive helpful reports on edHEALTH’s risk scores and the program’s return on investment.

Don’t Wait to Tackle High-Cost Claims and Gaps in Care

This program helps bend the rising healthcare cost curve; we’ve shared the program’s potential savings with our member schools effective January 1, 2019, or earlier. For additional information and to enroll, please contact our Operations Department. 

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