Health plans that assume risk in managing a population’s health risk can benefit from partnerships with organizations that can supplement and complement a health plan’s programs and services in a broad range of areas, including the following:
- Case management services, including consultative case management and case management seminars
- Transplant management programs and/or carve-out products
- Neonatal management
- Diseases management services, including cancer services networks, congenital heart disease networks, and kidney management services
- Forensic review
- Claim recovery
- Physician consultation
- Patient advocacy
- Pharmacy services, including specialty pharmacy, pharmacy benefit management, and transplant pharmacy
- Training and education
- Ancillary product solutions
- Medical management evaluation
- National PPO networks
- Provider negotiations
See related article: Population Health Management: Opportunities and Challenges for Captives
