InsightsCare Management

The 5 Pillars of Care Management

01 Feb, 20234:01 PM

Share this article
Streamline Your Medicare Advantage Operations
Get industry insights, best practices & regulatory updates delivered straight to your inbox.
The 5 Pillars of Care Management

The key to an effective healthcare strategy today is to utilize information systems to perk up the service quality. The need of the hour is to equip doctors with state-of-the-art IT facilities that can act not just as data storing devices but also as intelligent machines to assist in research-based decision making. Aside from the healthcare professionals, there is also a requirement of data analytics experts and well-informed case managers who can collaborate with the doctors to provide an all-around treatment game-plan for the patients, keeping in mind their histories. Care Management is a term used to describe the amalgamation of all these services. 

With the following five pillars of care management, doctors can function at their highest possible potential and provide top-notch assistance to patients- 

key benefits

1. Easily Accessible Patient Profiles

As shocking as it may sound, here in America a large number of physicians continue to use paper-based patient profiles. Paper-based records create inefficiencies and a risk of manual errors. It is imperative for a healthcare practice to adopt a digital solution for storing and accessing patient records. Such a system needs to be user-friendly, easy to maintain and quick to access.

2. Security and Privacy 

Today, when data protection and confidentiality is an increasing challenge, it is critical for healthcare workers to have the assurance that their patients’ medical data is stored in secure databases and is being processed in systems that are reliable from a privacy point of view. 

3. Data Analytics

There are deep treasure troves of rich medical data available today that can help physicians make a well-informed diagnosis and design treatment plans. However as the volume of such data is vast, there is a need for data analytics systems to be able to mull over such large quantities of data and extract results that can help provide optimum patient care . By having such a facility, physicians can improve the efficacy of service while reducing healthcare costs owing to misdiagnosis, task redundancies etc . 

4. Chronic Illness Management 

A physician can benefit a lot from the services of qualified case managers who can study case histories in depth and provide clinical decision support especially for those who are suffering from several chronic illnesses and need the attention of multiple specialists. Such case managers can help physicians in mapping a long-term treatment plan for vulnerable groups. Case Management is a good strategy for cost-containment as well since statistics prove that even though only 10% of the American population suffers from chronic ailments, they make up of 70% of the total healthcare expenses of the country .

5. Infectious Disease Management 

In the case of an outbreak, it is essential to have the support of experts who can stitch the pieces provided by the physician and those supplied by case managers to formulate a course of action that helps the individual patient as well as the affected community at large. Such experts can also provide three-pronged guidance in the areas of prevention, cure, and rehabilitation. 

key benefits

If you are looking at providing long-term ‘cradle to grave’ kind of services to your patients while being compliant with proper clinical protocols and guidelines, Mirra is just the partner for you. Mirra is a third-party administrator that provides the five pillars of care management and allows physicians to be well equipped to serve the people who rely on them for a healthy existence. Reach out to us at- Contact Us to request a demo for the services in our Medicare in a box solution. 

Back to topBack to top
Simplify Medicare Advantage with Advanced Solutions
Streamline healthcare ecosystem & enhance patient care with Mirra's Medicare Advantage in a Box.
Boost Revenue with Our
Complimentary CMS Reject Analysis
Leverage our in-depth CMS Reject Analysis to improve claim acceptance rates.

Reviews & Testimonials

testimonal-avtar-slider

NANCY GAREAUCEO of Ultimate Health Plans

"In 2021, Ultimate Health Plans (UHP) partnered with Mirra Health Care (Mirra) to develop a software platform to support processing Claims, Customer Service, Eligibility, Enrollment, Premium Billing, Encounter Processing and a Provider Portal for our Medicare Advantage Plans. Mirra collaborated well with our operations and compliance teams to successfully design and implement a system that was innovative, efficient, and compliant with all Medicare and Florida Medicaid guidelines and requirements all within the scope of our required timeline. We greatly benefitted from the Mirra Project Management Team’s regular communication with Stakeholders through monthly meetings and recurring weekly breakout-focused calls, which were geared towards troubleshooting and goal alignment. Mirra was able to quickly maneuver and adapt their systems to our needs, resulting in successful implementation and go-live. Mirra continues to support our compliant operation and growth in the ever-changing healthcare industry rapidly and effectively updating their systems with new Medicare and Florida Medicaid rates and guidelines to ensure seamless compliance and efficiency. I have absolutely no reservation in recommending their systems to any Payer searching for improvement in their operational efficiency."

Recover Revenues with Our CMS Reject Analysis!

Reach out for a no-obligation consult today.

We respect your privacy and do not sell or share your information with third parties. Please read our privacy policy here.