Patient Centered Enhanced Care Model (PCEC)
About the PCEC Model
The PCEC model focuses exclusively on the high-cost member-patients, most of whom have multiple chronic diseases, offering it to self-funded companies.
Healthcare Outcomes Solutions (HOS) utilizes Patient Centered Enhanced Care (PCEC) model to coordinate care and reduce health care expenses for high-cost patients in an outpatient setting. Multiple chronic conditions account for more than two-thirds of the health care cost in the U.S.
A distinguished panel of CEO’s that included Patricia Gabow, MD (at Denver Health), George Halvorson (at Kaiser Permanente) and Gary Kaplan, MD (at Virginia Mason Health System) commented in the Journal of American Medical Association (July 18, 2012) that “ Despite the increasing prevalence of multiple co-occurring conditions, the health care system does a poor job coordinating care for patients with complex conditions”, and that “quality of care must be improved with simultaneous reduction in costs”. Our PCEC program is designed to address these problems anywhere in the outpatient setting by improving the care of these patients and reducing the cost of total care.
How the PCEC Model Works
HOS works with the employer’s third-party administrator (TPA) to initially obtain the information about the health care cost focusing on the most expensive member-patients with chronic diseases.
Main Principles of the Model
• Eligibility of member-patients will be based on proprietary criteria for participation in the PCEC program.
• Care coordination and enhanced care of these patients will be provided by primary care physicians, specialists, nurses and other team
• HOS will continue to oversee the operation of the PCEC program after it is implemented specifically for each company. In addition, HOS
will offer educational updates, as well as communication skill development presentations and/or training when required.
How Does the PCEC Model Save Your Company Money?
The PCEC program reduces costs for the employer and the employee where it counts most. The PCEC program is in perfect accordance with employers’ emphasis on value-over-volume in health care. It also complements other measures to decrease health care costs that many self-funded companies have taken, such as wellness programs, employee education and involvement in their own care, and the use of consultations at excellence centers for high-cost procedures..
Care coordination is critical to improving the care of these member-patients and reducing health care cost. Each participating physician and his/her team will be focusing on effective care coordination.
The PCEC model focuses exclusively on the high-cost member-patients, most of whom have multiple chronic diseases, and it is offered to self-insured companies.
Health Care Cost Analysis
Request an analysis of your company’s current health care expenses to better understand your company's health care expenses and how to reduce the cost while improving care.
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