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An evolution to customized, cooperative employer-sponsored
healthcare. Every organization has a unique
profile in terms of its culture, employee demographics, and operational structure.
Integration is about developing customized health benefit and productivity improvement
plans that reflect organizational realities as well as the influences of marketplace
trends and the health stages of the population.
Simply, the healthcare continuum is a way to consider the healthcare needs of
individuals. At Cardium Health, we define the three continuum stages as:
- Healthy Living – members of a population in good health
with low risk,
- Living Healthier – members of a population with an elevated
health risk
and/or greater utilization, and
- Managing Health – members of a population with diagnosed
chronic disease
and/or catastrophic illness.
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Where an individual is on the continuum determines his or her rate of healthcare utilization
and associated costs. In traditional health benefit plans, there is enormous disparity
in that a minority of members represent the majority of costs. The goal of integrated
benefit plan design is to balance the scales by helping individuals become more informed
healthcare consumers, better manage their conditions, and reduce their utilization
of high-cost, intensive healthcare services.
An integrated benefit plan is not just health insurance. What was once a group insurance
industry has evolved into a series of subspecialties encompassing healthcare, disability
management, wellness, disease management, behavioral health, lifestyle management,
and more.
Viewed in the context of each company’s unique organization profile, the specific
needs to mix and match components will vary greatly. A company with an older demographic
will have a far greater need for heart disease management, whereas a company that has
a younger employee population is more likely to realize greater financial benefit from
wellness and primary prevention programs.
There is no “one-size-fits-all” answer.
Integration encompasses and coordinates care across the continuum to ensure that individuals
receive the right level of care, delivered by the right provider, at the right time,
wherever they are.
At Cardium Health, we work with employers to assist in the design of benefit plans
that reflect the organization's culture and recognize the demographic realities of
the plan population. We also consider other major influences including marketplace
and industry influences, business operations, safety programs, employee communications,
and existing healthcare and disability benefits.
Ultimately, however, integration is about working with each individual participant
where they are in terms of their health status, risk level, health knowledge, lifestyle,
and readiness to change. Often, individuals with multiple conditions may be at two
points on the continuum simultaneously.
Real integration requires a commitment to improving individual lives, rather than
adding lives under management. At Cardium Health, we strive to integrate our programs
with all other health and productivity initiatives offered by our customers. We advocate
for our participants by helping them to access those programs best suited to their
needs and coordinate care with other programs to ensure that each individual is being
treated as a whole, not a series of fragmented healthcare parts.
Integrated Disease Management [
PDF 61KB ]
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