The PerforMED® care management model incorporates the best practices in intensive case management, disease management and care coordination.  This holistic approach allows us to maximize the care for our members in this program.

The Problem

• Rising Medicaid costs
• Medicaid costs rising an average of 8.2% annually since 19951
• Increasing ABD/SSI population from 0.2% (1999) to 4.3% (2005 est.) of enrollees
• ABD/SSI members account for 43% or more of healthcare expenditures

• Risk bearing entities realize conventional medical management does not work and are looking for a solution.

The Solution: The PerforMED® Model

• Combines traditional elements of care, including primary care, disease education and case management, behavioral health coordination with predictive modeling technology
• Focuses resources on those recipients predicted to have the highest future costs
• Employs purposeful interventions designed to prevent avoidable episodes of care
• Results in demonstrated cost savings by reducing hospital admissions and emergency room visits
• Designed for health plan and government settings

PerforMED® “High Touch” approach includes:

Actuarially Proven Savings
Potential annual savings for 5,000 engaged members: $6 million with an ROI of over 2 to 1
 (based on experience at Keystone Mercy Health Plan: 2004-2005. Certified by consulting Actuary 2006)

Predictive Modeling & Stratification of Membership into Risk Groups
(Population cost breakdowns chart attachment)

To find out how PerforMED® can improve health outcomes for your members, contact Lynne Harsha at 215-863-5545.