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Healthcare Plan Case Studies


Case #1

A regional business unit of a large national healthcare plan desired to improve the level of patient satisfaction and quality of life for those members experiencing a serious and terminal medical situation.

Solution
The health plan implemented Vital Decisions’ Living Well Program for its’ most seriously ill patients. Patient and Surrogate satisfaction with the program and its impact on the member’s satisfaction with the plan were measured.

Results
83% of the respondents indicated that the Living well Program provided them with a sense of comfort and caring during a difficult situation. Additionally, close to 60% of the patients and/or their family members indicated that their satisfaction with the health care plan increased as a direct result of participating in the Living Well Program.

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Case #2

Realizing that many of its terminally ill members were not fully utilizing hospice services, a large national healthcare plan desired to improve member participation.

Solution
The health plan implemented Vital Decisions’ Living Well Program within a selected geographic region of its operations to evaluate the impact that the service would have on Hospice utilization and addressing their needs.

Results
Retrospective research and analysis revealed that across a population of members, some hospice appropriate and others not hospice appropriate, that in 20% of all cases the Vital Decisions program enabled patient selection of the hospice benefit. In addition, the median length of stay in hospice for Vital Decisions enabled members was significantly longer than plan experience.

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Case #3

The leadership of a managed Medicaid plan wanted to provide its members access to the Living Well Program, however prior care management efforts had been unsuccessful due to the difficulty of engaging their member population.

Solution
Vital Decisions and the plan developed a process to co-manage patients in a way that considered the unique characteristics of its member population and the plan’s internal processes and programs to ensure success and integration.

Results
Through the implementation of a customized patient management process engagement rates of the plan’s members were on par with those associated with a commercially insured population. In addition, the engagement of members in the program enhanced the ability of the plan’s case managers to maintain contact and increase access to improve the results of their case management initiatives.

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