New Century Health's delegated-risk model leverages a specialist network to drive down cardiovascular care costs and improve quality for a Medicare Advantage plan.
The Challenge
The client needed to deliver coordinated, high-quality cardiovascular care to 32,000 Medicare Advantage members assigned to its wholly owned, multispecialty provider network. However, managing cardiac care costs had become increasingly difficult in the client’s fee-for-service provider reimbursement environment. Lacking a comprehensive clinical review process, physicians frequently ordered cardiac procedures that were inappropriate, exposing patients to additional risks and increasing the cost of care.
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