The CORE Identifies Members with Hidden Disease Risk to Drive Focused Case Manager Conversations
A health plan case manager recounts a conversation he had with a member after being prompted by the Jvion CORE™
I opened the Jvion portal one day and saw that a health plan member had been flagged for his risk of an avoidable admission in the next six months. The man had been hospitalized for diverticulitis and a kidney stone eight months earlier. To prevent another hospitalization, the Jvion CORE recommended that I educate him on how to prevent infection and recognize the early signs of infection.
After reaching out, I was surprised to hear that this gentleman had never been taught the causes of diverticulitis, the changes he could expect in his body at the start of an infection, or how best to manage at home to minimize the risk of a medical emergency. Thanks to the prompting of the Jvion portal, I was able to teach the member how to avoid complications in the future and how to know when to seek assistance.
Through member interactions like these, a national health plan found they could save $3.7 million a year in avoided admissions.