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Keystone Mercy Health Plan Receives Thomson Healthcare Innovator Award
HealthLeaders News Brief, May 15, 2007
Keystone Mercy Health Plan was honored by Thomson Healthcare for its innovative use of healthcare data analytics to achieve significant clinical and business results. Keystone, a Pennsylvania Medicaid HMO serving 300,000 members, received the fourth annual Innovator Award from Thomson Healthcare, a business unit of The Thomson Corporation.
Keystone's winning initiative resulted in improved quality of life for chronically ill individuals while saving $7.8 million annually. The health plan adopted a proactive approach to case management--a strategy that targeted high-risk members with multiple chronic conditions and co-morbidities. These individuals represent a relatively small volume of Keystone's membership but use a disproportionately high volume of medical resources. Keystone found that 2 percent of the total member population was responsible for 14 percent of the plan's costs.
The Keystone case management initiative resulted in more effective care for plan members who benefited from ongoing guidance, screening and attention, as well as more efficient use of resources. The health plan used sophisticated analyses of medical claims data to identify members who would benefit from case management and to monitor and measure the program's progress.
Keystone's winning initiative resulted in improved quality of life for chronically ill individuals while saving $7.8 million annually. The health plan adopted a proactive approach to case management--a strategy that targeted high-risk members with multiple chronic conditions and co-morbidities. These individuals represent a relatively small volume of Keystone's membership but use a disproportionately high volume of medical resources. Keystone found that 2 percent of the total member population was responsible for 14 percent of the plan's costs.
The Keystone case management initiative resulted in more effective care for plan members who benefited from ongoing guidance, screening and attention, as well as more efficient use of resources. The health plan used sophisticated analyses of medical claims data to identify members who would benefit from case management and to monitor and measure the program's progress.
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