ABS Managed Care

Managed Care Systems

Collaborative Health Management Platform

ABS utilizes a powerful data platform which takes a member-centric approach to medical management, rather than a disease or episodic approach. ABS stratifies the population which accounts for most clinical costs as well as provides the clinical team with evidence-based clinical protocols, thereby improving quality and lowering costs. Through the use of this platform, ABS has developed an efficient workflow that integrates utilization, case, disease, and population management into a single source.

The ABS clinical team will work with the identified beneficiaries to develop a patient-centric individualized plan of care. The plan of care incorporates all of the necessary parties including the PCP, SCP, patient caregivers, family, etc. The ability to integrate clinical data from the physician EMR, laboratory data, and gaps in care enables the ACO providers within their own practice to address the issues identified that affect clinical outcomes and financial performance.

Population Health

The second core component of the ABS managed care program is a tool that manages clinical and financial risk. Effective tools that identify and target risks in the covered population are essential to measure and monitor ongoing programs for effectiveness and to help identify areas where different clinical interventions can improve health outcomes and reduce the plans costs. The system identifies gaps in care, as well as a potential likelihood of hospital or emergency department visits. ABS provides routine reporting and can also develop customized reports based on client needs. Basic reporting includes:

  • Population Based Metrics
  • Utilization Metrics
  • Disease Registry
  • Executive Summary
  • Gaps in Care