We Get Better Financial Results Through Patient Outcomes

Health Plans

SMM provides health plans with a cost-effective means of managing members in Medicare, Medicaid and Commercial lines of business. We have saved our partners millions of dollars in just readmission prevention and preventable hospital and emergency department admissions. We provide our partners with solutions that are more affordable than hiring additional staff and guarantee outcomes required for successful quality, compliance, productivity and financial operations.

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 Practice

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:

NCQA PCMH Readiness

We have an NCQA PCMH CCE on staff with an experienced practice and care management team to help practices transition to a meaningful PCMH and achieve NCQA recognition. Achieving the recognition of an NCQA PCMH is more than closing HEDIS Gaps, or quality reporting. An NCQA PCMH is designed to create a medical home where the clinical, psychosocial and well-being needs of patients can be addressed effectively. The patient is at the center and in control of their care. With PCMH the patient experiences higher clinical and service satisfaction as well as quality outcomes required in value-based care. We not only provide a PCMH readiness evaluation, but help practices build meaningful programs that will actually produce shared-savings through better patient outcomes. We have partners in practice management, revenue cycle and data analytics that provide affordable recommendations to PCMH practices. If you are interested to see what your practice needs to optimize value-based contracting let us know.

SNF Management

SNF Management cannot be done by phone. We provide effective Embedded SNF Managment to prevent readmissions, manage LOS and ensure proper transitions from the day of admission. We understand SNF operations and the challenges they face. With that knowledge we can assist SNF clinical teams in planning safe care for the patient and ensuring a safe return home.