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KEPRO Case Management improves the health of members while decreasing care costs associated with episodic health events.
Obtain Vital Services Without Costly or Unnecessary Expenditures.
Hospital admissions and readmissions, plus the unnecessary use of emergency departments, medical services, and equipment can send your costs skyrocketing. That’s why you need the advanced, comprehensive Case Management services only KEPRO can offer. We promote cost-effective quality outcomes through frequent communication and coordination among our RN case managers, each member, healthcare provider, family or caregiver, other vendors, and community resources. Our program is completely voluntary for members.
Case management is necessary when members have:
- Acute healthcare needs, diagnoses, or hospitalizations
- Complex medical issues and co-morbidities
- Complex hospital discharge requirements
- Complex social issues
We Target Potential High-Cost Claims Before They Happen.
Eligible members at greatest risk for high cost medical claims are our primary targets. We empower members to take control of their health, make informed healthcare decisions, and work more collaboratively with their physicians. Each of our RN case managers is an extension of the member’s physician practice. We work collaboratively with physicians to help members realize their health goals.
We Provide Care Transition Management for Post-Discharge Patients.
Care Transition management targets eligible members requiring short-term coordination beyond their discharge from an acute care, rehabilitation, or skilled nursing facility. While the member is still hospitalized, our RN case manager calls, (or visits the facility), and involves the participant’s family, and their physician to facilitate post-discharge follow-up, reconcile medications, and coordinate services. Transition management follows the member post discharge for up to 30 days. Our goal is to prevent readmissions and increase compliance with physician prescribed treatment plans.
KEPRO Can Administer Complex Case Management for Your Most Costly Members.
KEPRO Complex Case Management is a longer term, intensive support program for high risk and at-risk individuals, the most costly one-to-two percent of your population. We emphasize appropriate utilization and access to services and the most effective care, and act as an advocate for each member. Our case managers help members understand and comply with prescribed medications and keep follow-up visits with providers. Better self-management improves quality of life and reduces costs.
Our program focuses on:
- Cancer, transplant, end-stage chronic disease, serious co-morbidities, and multiple chronic conditions
- Care involving multiple providers that is often not coordinated
- Serious psychological, pain management, social problems, and other potential cost drivers
We Bring Added Cost Efficiency to Clients with Stop Loss Relationships.
Our Care Coordination program proactively manages all cases identified as eligible for case management, without requiring member consent. We target eligible members who require coordination of services to ensure they are getting the right care at the right time, according to their benefit plans. RN case managers also work with each member’s medical team to coordinate healthcare needs. Care coordination allows our case managers to track, monitor, and report health utilization. This results in early, proactive management of your members and increased savings and return on investment for you.
Consider Optional KEPRO Services that Can Add Value.
If our clinical experts have concerns about the validity of a phone interview, or the member’s condition is so complex that telephone outreach may be inadequate to truly assess the expected treatment course, our medical director may authorize an onsite assessment.
24/7 NURSE ADVICE LINE & COVERAGE
Our 24/7 Nurse Advice Line provides vital and compassionate support to members, from simple first aid to calming instructions in a life-threatening situation. Our nurse advice line uses advanced technology and evidence-based software to provide personalized support any time, day or night.