ENCOMPASS Case Management
ENCOMPASS' highly qualified nurse case managers work to identify and address the individual care needs of people experiencing catastrophic and acute events. Once an appropriate case is identified, a dedicated nurse:
- Works to implement care alternatives and prevent unnecessary hospitalizations, services and procedures for:
- Patients with catastrophic and acute events resulting in high-dollar/high volume use of medical services
- Patients discharged from inpatient admissions with post-discharge needs
- Patients with transplant or transplant-related medical service needs
- Collaborates with physicians, treatment facilities and family members regarding treatment plan and ongoing care coordination needs
- Provides ongoing monitoring for exacerbations and new conditions
Customizing Solutions
Case Management is one of the full range of ENCOMPASS Health Management services offered. We work with each client's health plan requirements to build a customized profile from our comprehensive Care Coordination and Medical Management solutions.
As with all ENCOMPASS services, Case Management case information is completely integrated in our proprietary software system, QualiTrac, which supports documentation and reporting for all programs. QualiTrac is a member-centric system making information available to ENCOMPASS medical professionals to address health status and medical needs across all Care Coordination and Medical Management programs.
Improving Outcomes
For more than 20 years, our commitment to supporting the right care at the right time in the right setting has created successful partnerships with members, clients and health care providers. Because we work to improve the quality of medical care received as well as eliminate unnecessary treatment, health care costs generally decrease due to improved outcomes.
To help ensure our services conform to best practices in the industry, our Case Management program has been continuously accredited since 1999 by URAC, a respected accreditation organization.
Demonstrating Results
ENCOMPASS' Case Management program value is demonstrated through report packages documenting improved health outcomes, health care savings and return on investment. All reports are specific to the individual client.