Care Management Engagement Analytics Yvette Neri-Hernandez, BCBS AZ - PowerPoint PPT Presentation

Care Management Engagement Analytics Yvette Neri-Hernandez, BCBS AZ and Mary Henderson and Penny Monical, BHI

Our Speakers Today Yvette Neri-Hernandez Mary Henderson Penny Monical Manager, Analytics Senior Vice President, Product Manager, Strategy and Data Science, Product Strategy and Innovation, BHI BlueCross BlueShield and Innovation of Arizona 2

Agenda • Health Plan Introduction • Analytics and Data Science Team • Care Management Program • whYzen Integration • whYzen Demo Proprietary & Confidential Proprietary & Confidential | 3

Health Plan Introduction BlueCross BlueShield of Arizona • Not-for-profit • Independent licensee of BCBSA Flagstaff • 1.5 million covered Lives • More than 1,500 employees Phoenix Chandler Tucson Proprietary & Confidential Proprietary & Confidential | 4

Health Plan Introduction Segmentation of Business BlueCard 37.2% CHS/Network Rental 13.1% 7.2% Federal Employee Program 7.6% Small Group 6.7% Medicare Advantage/ Medicare Supplemental 23.5% 4.7% Large Individual < 65 Group Local, Blue-Administered Proprietary & Confidential | 5 Proprietary & Confidential

Our Analytics and Data Science Customers External Audiences Internal Plan Constituents • Consumers/Members • Finance • Providers • Operations • Employers • Customer Service • Benefits Consultants • Provider Relations • Third Party • Sales and Marketing Administrators • Clinical Affairs Note: Bold italicized text indicates Current whYzen use cases at BCBS AZ. Proprietary & Confidential | 6 Proprietary & Confidential

Analytics That Inform Better Decisions Clinical/Quality Provider Performance • Population Health • Provider Reimbursement Program Evaluations • Clinical Algorithms • Fee Impacts and Implementation • Medical Management • Hospital Negotiations System Performance Analytics • HEDIS/QRS Measurement • PCMH Programs and Analytic Strategy • Value-Based Care Reports Arrangements Proprietary & Confidential | 7 Proprietary & Confidential

Care Management Analytics for Our Care Management Programs Healthy Low Risk At-Risk Chronic Complex Case Disease Management Proprietary & Confidential Proprietary & Confidential | 8

Care Management Program Identify Members Evaluate and Improve Screen Measure Outcomes Outreach Establish Goals Proprietary & Confidential Proprietary & Confidential | 9

Care Management Program Identify Current Identification Triggers Members • Inpatient notifications/precertifications Evaluate and – Behavioral health admissions Improve – Pediatric admissions – Multiple and readmissions Screen • High cost claimants Measure • Frequent Emergency Department utilizers Outcomes • Pending claims • Health Information Exchange (HIE) data Outreach Establish Goals Proprietary & Confidential | 10 Proprietary & Confidential

Care Management Program Identify Measuring Program Outcomes Members • Develop population cohorts Evaluate and – Engaged vs. non-engaged Improve – Levels of engagement • Review and measure program goals Screen – Reduced admissions and readmissions Measure – Reduced ED visits Outcomes – Closed care gaps – Improved medication and adherence Outreach – Increased PCP visits Establish Goals Proprietary & Confidential | 11 Proprietary & Confidential

whYzen Integration of AZ’s Care Management Data whYzen Utilization Wellness Management Disease Case Management Management Proprietary & Confidential Proprietary & Confidential | 12

whYzen Integration in Action DM_ DNC_ Member_ID YrMo cm_prg cm_status DM_prg DNC_Dt status Status xxxxxxx67-01 2019/09 TOC Case No Mbr Response xxxxxxx73-01 2019/09 Screening Reviewed xxxxxxx95-01 2019/09 Asthma Disenrolled xxxxxxx55-01 2019/09 TOC Case No Mbr Response xxxxxxx59-01 2019/09 Complex CM Goals Met/Issues Addressed CHF Education xxxxxxx27-04 2019/09 TOC Case No Mbr Response xxxxxxx00-01 2019/09 TOC Case Goals Met/Issues Addressed xxxxxxx83-01 2019/09 COPD Education xxxxxxx44-01 2019/09 TOC Case No Valid Demographic Info xxxxxxx79-04 2019/09 TOC Case Goals Met/Issues Addressed xxxxxxx49-03 2019/09 TOC Case No Mbr Response Diabetes Education Y 10/7/2019 Proprietary & Confidential | 13 Proprietary & Confidential

whYzen Analytics • Executive Dashboards • Guided Analytics • Interactive Analytics • Risk-Adjusted Plan Benchmarks • Automated Narratives • Published (Static) Reports • Report Scheduler • Data Extracts • Mobile Enabled 14

whYzen at Work 15

Thank you

Care Management Engagement Analytics Yvette Neri-Hernandez, BCBS AZ - PowerPoint PPT Presentation

Care Management Engagement Analytics Yvette Neri-Hernandez, BCBS AZ and Mary Henderson and Penny Monical, BHI Our Speakers Today Yvette Neri-Hernandez Mary Henderson Penny Monical Manager, Analytics Senior Vice President, Product Manager,

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Care Management Engagement Analytics Yvette Neri-Hernandez, BCBS AZ - PowerPoint PPT Presentation

Care Management Engagement Analytics Yvette Neri-Hernandez, BCBS AZ and Mary Henderson and Penny Monical, BHI Our Speakers Today Yvette Neri-Hernandez Mary Henderson Penny Monical Manager, Analytics Senior Vice President, Product Manager,

Rhody Health Options Care Management Kathy Ullrich, LICSW Manager, RHO Care Management ICI

CONNECTED CARE THE CHRONIC CARE MANAGEMENT RESOURCE Connecting to Chronic Care Management

Enhancing Medicaid Primary Care Case Management to Improve Care Management and Accountability

Chronic Care Management Services Webinar Delivering Coordinated Care through Chronic Care

March 15 Tom Bodenhemier MD Maximizing Care Management; an emphasis on care/case

Improving Care &amp; Reducing Costs with Hotspotting &amp; Community-Based Care

Health Management and Social Care NSS Health Management and Social Care Curriculum Management,

TREE CARE 101 Bob Layton, American Forest Management CITY OF SAMMAMISH URBAN FOREST MANAGEMENT

Effective Care Management for Behavioral Health Integration Title: Ef Effectiv ctive Care

Cal MediConnect: Care Management &amp; Collaboration to Achieve Patient- Centered Care for Duals

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Integrated Healthcare Management (IHM) Overview MCO Case Management Presentations MCAC on June

CONNECTED CARE THE CHRONIC CARE MANAGEMENT RESOURCE Connected Care Partner Toolkit PowerPoint

IKOR of Western Pennsylvania www.ikorglobal.com 1 LIFE CARE MANAGEMENT FOR SENIORS AND

Age Age Appro Appropriate priate Care Care &amp; Pa Pain Manage in Management ment Self

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