Through Health Program Integration, Claremont Partners creates referrals between programs that otherwise operate in silos. Separating EAP from managed mental health, for example, is a best practice but without ongoing coordination there was risk of administrative confusion and inappropriate utilization. Claremont Partners provided that coordination so that both vendors met members needs at the appropriate point, maximizing the value of the programs. Claremont Partners’ staff provided expertise to facilitate a discussion, explore clinical priorities, mediate differences, and assure that the final plan met both vendor and client goals.
Primary Care Coordination
Claremont Partners helped established a Primary Care Medical Home to help a self-insured payer struggles with the inadequacies of the existing medical delivery system. The project rewards physicians for accomplishing the following goals:
· Blood sugar, blood pressure, and weight control for diabetic members
· Screening and referral for depression
· Reduced avoidable hospitalizations
· Patient Satisfaction
· Complex Care Manager Contacts
Claremont provides an integrated calendar with bi-annual reporting for each vendor funcion. Each vendor report uses the same format for utilization reports, news updates, communications, and key goals of the program. Structuring the data in this manner supports systematic review and planning by the fiduciary.
Wellness Program Design
Claremont Partners led design of an on-site wellness from for Fresno Unified School District. The wellness program improves employee health and keeps health plan costs down. Both labor and management personnel participate as day-to-day ambassadors of the program.