Medical Director Services (Care Management)
Progressive Healthcare helps clients meet transformation challenges by offering integrated Medical Director Services with our financial and management solutions. This helps facilitate provider engagement in key initiatives which, in turn, drives favorable patient engagement, along with clinical, service, and financial outcomes.
Our Focus Areas:
Wellness - Health Risk Assessment, health fairs, comprehensive reporting
Preventive, primary and chronic care
Worksite clinics (including direct employer contracting, clinic development and operations)
Patient-Centered Medical Home
Patient education (wellness, chronic condition)
Disease management coaching to clinical outcomes
Gaps in care management
Strategy that leverages care management for competitive advantage:
Clinical program growth
340B optimization
Medication Therapy Management (MTM)
Formulary development and other PBM / pharmacy services alignment
Chronic Care Management (CCM) / Transitional Care Management (TCM)
Care plan strategy, including ROI optimization plans
Network development for:
Care management and risk-sharing
Payment re-design
Incentive alignment
Health plans (specifically provider-owned), including own-employee plans:
Clinical and benefit program evaluation, strategy, implementation, and outcomes
Consumer engagement assessments and program development
Care Coordination and Case Management outcomes performance analysis
Medical Home: strategy, implementation, outcomes
Payment system design and transformation
Delivery system transformation and improvement initiatives
PBM evaluation
Employers
Benefit plan outcomes performance
Cost and utilization pattern analysis
Network performance evaluation and narrow network development
Center-of-Excellence development
On-site clinic strategy and implementation
Incentive design for employee engagement in wellness & disease management programs
Provider system care integration and optimization
Risk-sharing with provider systems
PBM evaluation