HEALTHIER MEMBERS AND COST CONTAINMENT CAN CO-EXIST

Cost containment is a significant challenge for most Taft-Hartley health plan administrators who are concerned about their plan’s financial sustainability. Most health management vendors only focus on controlling member utilization of covered benefits for cost containment. At Telligen Health and Well-Being, we increase productivity and reduce costs by helping your members actively engage in their own health decisions wherever they are on Spectrum of Health™. Telligen delivers a proven, holistic approach that enables your members to make more educated decisions for healthier outcomes and overall cost containment in addition to managing utilization.

Telligen Health and Wellness Solutions

Wellness Programs: Members are more engaged with interactive tools and the support we provide to ensure a culture of well-being.

At-Risk Coaching: Our health coaches help slow the onset of chronic disease for individuals with metabolic risk factors who are in a “pre-disease” state through education and support tailored to each employee’s specific risk factors.

Diabetes Prevention Program: Telligen, in partnership with the American Diabetes Association, offers the Diabetes Prevention Program (DPP), an expert-led, 52-week program based on the groundbreaking NIH study showing that a comprehensive behavioral weight loss program can help people prevent diabetes, and do so even more effectively than medication.

Disease Management: We use data analytics to expertly identify individuals with chronic conditions, such as diabetes, congestive heart failure, coronary artery disease, depression, COPD, sleep apnea and asthma, and who will clearly benefit from nurse health coaching. Our nurse health coaches work with your members to understand their conditions, coordinate treatments with healthcare providers and monitor their progress so health is maintained and costs are managed.

Case Management: In the face of a catastrophic medical situation, such as a heart attack, traumatic injury, or an inpatient behavioral health event, we collaborate and coordinate with physicians and your members to help achieve their goals for ensuring better outcomes.

Specialty Programs: We can tailor a program to fit more critical medical needs of your members. Programs can include oncology management, transplant management, end-stage renal disease management, care transitions and emergency department programs.

Maternity Management: We focus on the care and needs of your members needing maternity care, including those at high risk. We promote the length of the gestational period and improved outcomes for newborns.

Utilization Management: Using evidence-based guidelines, our team of highly skilled nurses help your members understand their plan and the options they have for receiving high-quality, affordable care.

Employee Assistance Program: We provide counseling, financial and legal consultation, elder care and other services designed to help members and their families overcome problems life sends their way.

Telehealth: Members and their family receive customized care they need when they need it by board-certified medical providers and care team members available 24 hours a day, 7 days a week.

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Telligen Case Study

New Partnership. Immediate Impact.

Connecticut Carpenters, a union with 5,000 members, started health-management programing in January 2005. After nearly 10 years with a previous vendor, costs soared and the plan became unsustainable for its members in terms of increased contributions.

In January of 2015, Connecticut Carpenters and Telligen partnered to begin offering utilization and case management services. Just one year after implementation, the client had already realized a positive impact in hospital utilization and per member/per month costs.

 

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