Since 2016, Telligen has administered a Medicaid utilization management and quality improvement (QIO) program with the Idaho Department of Health and Welfare (IDHW). We’re proud to announce that we’re not only helping to save taxpayers millions, but the program is also achieving a return on investment of $6 saved for every $1 spent.

The program and helps achieve these savings through delivering QIO services and utilization management state-wide. They ensure medical services are authorized only when medically necessary, and that members receive those services effectively and efficiently in the most appropriate clinical setting. Telligen also reviews inpatient behavioral health and care coordination for extremely high-risk, high-acuity members with co-morbid physical and behavioral health issues.

Telligen provides further value through its QualitracTM portal. This proprietary system helps to greatly streamline the review process using automatic authorization capabilities, cutting down on time and costs for both providers and IDHW. Qualitrac also provides analytics insights to help IDHW implement data-driven strategies.

“We’re very excited to be able to deliver results such as this for the state of Idaho,” said Bill Phipps, vice president of state health solutions with Telligen. “It’s one more example of how we’re able to bring together expertise and innovation to help bend the healthcare cost curve nationwide.”