Care Management

Can your organization benefit from a care management model?

Condor can help your healthcare organization develop and implement the most efficient care delivery model to serve your patients or your members.

Case / Care Management for Health Plans

Condor can help your benefit plan identify services and opportunities that can be performed by external allied providers who can implement intervention strategies, achieve cost savings and improve quality of life and satisfaction.

• Network Development: Align yourself with providers and solutions that can deliver real time observations, documentation and services to affect member hospital recidivism and emergency room encounters.
  • Impartial comprehension review of provider network with cost-effective recommendations to fill gaps, enhance quality and improve member satisfaction.
  • Delegation of services, enhanced services, building or expanding provider networks via IPAs, MSOs, ACOs.
• Disease and Event Management: Keep members out of the hospital system through specific programs designed for high acuity level members, including education for members to better self-manage their conditions and wellness.
• Condor Serves: Health Plans, Insurance Carriers, HMOS, Managed Care Organizations, TPAs

Case / Care Management for Providers

Condor can help your provider organization or network locate and realize opportunities to expand your services as an augmentation to your current scope of offerings.

• Identify and remedy unnecessary program expenditures.
• Key focus on compliance, patient satisfaction and providing added value service.
• Pay for Performance (P4P), capitation and risk agreements.
• Implementation of disease specific programs to reduce risk migration from “at risk” to “diagnosed.”
• Serving: Home Healthcare, Case Management & Utilization Review Providers, Senior Adult / Social Daycare Programs, Hospitals & Acute Care Facilities, Ancillary Providers, Disease & Event Management Organizations, Healthcare Systems, IPAs–MSOs–ASOs. Skilled Nursing, Subacute and Adult Living.

Utilization Review

Condor provides data analysis and clinical services for utilization review/case management in both commercial fee for service and Medicaid managed care programs.

• State Licensure: Submissions of policies and procedures, along with required applications.
• Program Development: Condor’s services are designed to enable you to expand your services, recognize your economy of scale, and maximize cross-program resource utilization.
  • Avoid unnecessary expansion expenditures.
  • Step-by-step processes to develop, operate and promote your new program.