Insurers

 

Employers | ACO & Physician Group | Senior Living | Hospitals & IDNs

Intelligent Care. Connected.

Health Insurer Utilization and Outcome management


myNEXUSTM is a revolution in care management for insurers, Medicare Advantage, Accountable Care Organizations and integrated delivery networks.

 

The need for myNEXUS

  • 1 in 4 Americans suffer from multiple chronic conditions.
  • 60% of patients with chronic diseases are between the ages of 18 and 64.
  • 1 in every 4 patients discharged from the hospital to home health are being re-hospitalized in less than 30 days.
  • More than 75% of healthcare costs are due to chronic conditions.

myNEXUS Provides:

  • technology-driven care management services for individuals to keep them healthy and independent in their homes.
  • administrative and benefit utilization management services delivering quality outcomes for Home Health, Nursing, IV, Therapy and DME needs.
  • individuals a connection to the appropriate care at the right time.
  • lower costs to the healthcare system by delivering a more cost effective care model.
  • upfront assessment of historical payment integrity to identify cost containment opportunities for home health and DME services.
  • proactive identification of undiagnosed disease states through daily interaction ensuring accurate risk adjustment factor scoring.
  • assurance your population of individuals remain in your system mitigating leakage.
  • the ability to increase your STAR quality ratings through daily positive interaction with the Member.
  • the ability to take advantage of post acute savings on risk contracts and other bundled payment initiatives.

Proven results

myNEXUSTM has a technology-driven care management team with a proven track record that has reduced 30 day readmissions by 80%




 

Experience the difference myNEXUS can make.

  • Individuals are connected to high quality care managements services.
  • Actionable information results in lower healthcare costs.
  • Daily oversight ensures a more cost effective delivery model.
  • Business intelligence extends utilization management and into the home.
  • myNEXUS collects encounter data and can improve quality ratings.
  • The brand is extended into the home.
  • Individuals live healthier, independent and empowered lives.
  • Individuals’ benefits are managed effectively by delivering quality outcomes including home care, IV, Nursing, Therapy and DME needs