New Claims System Update

How IntegraNet Health Works with Health Plans

IntegraNet Health works closely with various health plans to ensure quality healthcare is provided to our patients while streamlining processes and minimizing costs. Our continuous care coordination allows medical specialists to thoroughly treat patients, share medical information with the physicians in our system and improve the overall health of our patients. By ensuring quality preventive care, we’re often able to prevent other illnesses and get patients back on the road to health. Health plan providers appreciate the proactive nature of our business and the overall improved health of our patients.

How Our Care Coordination Program Works

Whether our patients are seeking routine medical care or need a hospital visit, IntegraNet Health physicians and staff are ready.

Medical Home

A medical home is a 24/7 primary care access point and the primary source of the most routine medical care received by patients. It is a cost-effective, primary care alternative to the emergency room and hospital setting. Medical Home care consists of a home-based nurse or nurse practitioner and the primary care practitioner’s office. The medical home’s goal is to steadily improve the health and wellbeing of its patients, while reducing the overall costs of delivering medical care.

Our team of nurse practitioners focuses on patient care outside of the doctors’ offices. During home visits, a specialist conducts an environmental assessment, a physical exam, a medication review, member education and an assessment of their home care needs. This trained staff member supports the patient and reports back to the primary care physician. By regularly monitoring patient progress and providing continuous feedback to the patient’s physician(s), we can improve the care provided and allow physicians to focus on the patients requiring doctor visits. Our experience with the Medical Home care model indicates that patients are pleased with this approach.

Hospitalist Program

IntegraNet Health also works with hospitalists or physicians specializing in the care of hospitalized patients. Hospitalists provide more individualized and coordinated care for the hospitalized patient, while alleviating the time and financial constraints for primary care physicians.

In fact, our research shows that hospitalists reduce the length of stay and treatment costs as well as improve the overall efficiency of care for hospitalized patients. These key individuals are leaders on several quality improvement initiatives in areas such as transition of care, co-management of patients, reduction of hospital-acquired diseases and optimal patient care.

Rewarding Solid Performance

IntegraNet Health also requires physicians to comply with strict compliance regulations and reporting. We provide in-depth training on coding, HEDIS® reporting and more. Plus, we serve as a best practices consortium, sharing with our members innovative ways to serve patients,  using a set of performance measures that compare how well a plan performs in:

  • Quality of care
  • Access to care
  • Member satisfaction with health plan and doctors

In fact, our proven pay-for-performance system has also been recognized by insurers for better documentation and healthier patients.

IntegraNet Health Advantages for Health Plan Providers:

  • Improved quality metrics

  • Better documentation

  • Lower costs as doctor visits decrease and the length of hospital stays decrease

Are you a health plan provider looking to expand your network? Contact us today to learn how you can join the IntegraNet system.

Connect to our Health Plan Providers

Both aspects of care coordination keep the patient as the focus and allow a group of medical specialists to thoroughly treat patients while sharing medical information to improve the overall health of patients, streamline processes and reduce costs. 

For details on the health plans that are already part of the IntegraNet Health system, please visit the following health plan providers’ web sites.