care management

Better Outcomes. Better Care. Lower Costs.

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what we do

Telligen’s care management program pairs high-risk members with licensed health professionals to form individualized care plans that promote wellness and reduce the use of emergency services and inpatient care so participants can be living their healthiest lives.

“My health coach always listens to my questions and concerns and offers me helpful answers and ways to address them. She gives me great information on the phone and by mail. It feels nice when she calls to see how I’m doing on the health plan we made – it drives me to want to do the best I can.”

Health Management participant

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how we do it

We provide a workflow-driven solution that guides a participant and their care team through the Care Management process. Backed up by our proprietary data management application, Qualitrac™, we’re able to provide real-time stratification, assessments and other insights critical for developing and maintaining person-centered planning efforts.

Our programs include the following:

Population Health Management

Our population health management services go a step further by engaging providers in practice transformation goals related to prevention, wellness, care coordination and quality improvement.

Disease Management

Our coordinated, proactive approach ensures members receive the appropriate services, are educated on preventive measures, and able to navigate the healthcare delivery system.

Care Coordination

Telligen professionals work one-on-one with members to streamline care for those whose conditions require services that span multiple providers and settings.

success story

Client & Program: Utilization and Care Management, Idaho Department of Health and Welfare

Description: Provide statewide Quality Improvement Organization (QIO) services and a utilization management program to ensure medical services are authorized only when medically necessary, and that members receive those services effectively and efficiently in the most appropriate clinical setting. We also review inpatient behavioral health and care coordination for extremely high-risk, high-acuity members with co-morbid physical and behavioral health issues.

Result: 

  • Approximately $5 million cost savings in 2019
  • Return on investment savings of $6 saved for every $1 spent

state solutions

assessments

care management

quality & performance improvement

quality measurement & reporting

utilization management