SMM provides health plans with a cost-effective means of managing members in Medicare, Medicaid and Commercial Models of Care. We have saved our partners millions of dollars in just readmission prevention and preventable hospital and emergency department admissions. In most cases, we have provided our partners with solutions that are more affordable than hiring additional full-time care management staff.
Accountable Care Organizations
We help Accountable Care Organizations increase shared-savings by providing affordable care management solutions and individual services to manage populations as well as working with their physicians and physician groups to implement meaningful NCQA compliant Person-Centered Medical Home programs that actually manage patient risk and costs.
Physician practices struggle to implement meaningful care management, population health, quality, and patient analytics that prepare them for value-based contracting with health plans, ACOs and CMS. SMM assists physician practices by conducting NCQA PCMH readiness evaluations and assisting the practice in designing and implementing solutions that work to increase their shared-savings at the end of the year. We provide the structure and ongoing oversight of PCMH programs for the practice in a risk-based arrangement making our solutions affordable and cost-effective.
By partnering with SMM, Health Plans, ACOs and Physician Practices achieve cost-savings that result from:
- Lower Preventable Hospital Admissions
- Lower Readmissions
- Lower ED Visits
- Lower Lengths-of-Stay
- Lower Non-Compliance
- Lower Redundancy and Unnecessary Service Use
- Lower Inappropriate Level-of-Care Determinations
- Lower Staff Hiring Costs to Meet Temporary Increases in Care Management Services
- Higher Quality and Member Satisfaction Scores