HEALTH, QUALITY & FINANCIAL OUTCOMES

BETTER HEALTH OUTCOMES

We are dedicated to doing all we can to improve the life of every person and provide every opportunity for each person to achieve health and well-being.


Understanding the complex relationships between physical health, behavioral health and perceptions of well-being is paramount to our success.
Helping patients discover, understand and prioritize their problems and needs based on these complex relationships is where we excel. We believe in Patient-Centered Planning Principles making patients the drivers of their care. Through effective predictive health analytics, we can anticipate the course of care and anticipate future problems and needs.


Through careful assessment, person-centered planning, analytics, and patient guidance, we have achieved higher engagement, compliance and outcomes for patients and our partners.


QUALITY OUTCOMES


SMM adheres to accreditation agency standards for case management including the National Committee for Quality Assurance, The Joint Commission, Commission for Case Management Certification, and the Centers for Medicare and Medicaid Services. However, SMM goes beyond minimum requirements employing technologies to better locate and engage patients and perform analytics to better identify interventions that do the most good for the patient.


We train our case managers on the intensive community care management so they are able to operate at a much higher-level. SMM ensures that our case managers understand the critical importance of addressing the clinical, social, behavioral, and well-being needs of each patient.


As a result, SMM has achieved a 95% successful patient engagement rate; achieved a 5% 30-Day All-Cause Readmission Rate; achieved a 5.5% 30-Day All-Cause Readmission Rate for patients with LACE Scores greater than 15-20; and, achieved a 100% LTSS Waiver Application Approval.


FINANCIAL OUTCOMES


SMM manages patient risk effectively through the use of intensive care management coupled with predictive analytics to address the clinical, social, behavioral, and well-being of each patient; as a result, SMM keeps patients from unnecessary complications, hospitalizations and other escalations in care that are costly.
SMM has saved our partners millions of dollars by managing patient risk effectively and reducing overall Medical Loss Ratio for Health Plan Partners 3-5%.
SMM is value-based care and we share risk with our partners because we are confident in our ability to achieve the optimal clinical, quality and financial outcomes for high-cost and high-risk patients.