Medical Cost Management

Delivering Results:  Enhancing Care

Increased government regulations, increased health care consumption, and costly new medical technologies continue to fuel rising medical care costs.  How can employers minimize costs when the price of medical treatment continues to rise?

At ASR, our results-driven approach gives our clients an advantage by offering new and different strategies and better alternatives to more traditional managed care plans.  Our medical cost-management services include the following:

Care Review targets health plan costs with a proactive emphasis on overall health management.  We apply hospital stay pre-certification, health management, disease management, and large-case management to control costs.

Pre-certification is used to evaluate each employee’s treatment plan and the employee’s need for inpatient or outpatient care.  Our program combines medical expertise with nationally recognized criteria and treatment guidelines to determine the most appropriate course of medical treatment.

Health management combines a wide range of programs to review and analyze your company’s health status.  From initial screenings to continued health education, health management can have a positive impact not only on the health perceptions and lifestyles of employees but also on your company’s bottom line.  The goal is to identify and address potential serious health risks before they become chronic illnesses requiring ongoing treatment, hospitalization, prescription medications, or surgery.

Disease management is an integrated approach designed to lower the cost of care for chronic illnesses such as diabetes, high blood pressure, or hypertension.  We encourage disease management in order to minimize the complications associated with chronic conditions and to help reduce future expenses.  We also work with clients to educate employees and their families on lifestyle modification.  Results are achieved with the help of counselors, physicians, nurses, and educational resources such as disease-specific Websites, newsletters, and more.

Large-case management is provided to improve the quality of care and control costs during inpatient stays through appropriate discharge planning.  Alternative treatment options are considered and savings negotiations are conducted for some care.  Because large-case management is typically associated with serious health conditions, the opportunity for savings can be significant.