Risk Management Solutions

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The ability to effectively quantify and mitigate patient health risks is essential as the fields of behavioral health and population health management continue to evolve. A thorough and comprehensive patient risk management plan helps to strengthen a healthcare organizations’ operational and financial strategy.

MAP’s Risk Management software includes the ‘Three P’s’ to help you Predict, Prevent, and Prepare for the unexpected:

Predict potential risks in your patient panel in order to determine who is at risk to relapse, who is not receiving quality care, and who has experienced a total cost of care that has exceeded the agreed structure with health insurance payers.

Prevent unnecessary admissions by coordinating care, provide quality care by identifying care gaps, and understand cost implications of different care pathways.

Prepare your team to understand patient risk by using data analyses and plan end-to-end patient episode management.

Why is Risk Management in Behavioral Healthcare Necessary?

Investing in Risk Management

Effectively managing patient risk can save your facility critical dollars in a fee-for-value, performance-based contract which will help your facility maintain its revenue stream and position you to increase revenue through greater efficiencies. In a healthcare paradigm that has grown increasingly competitive, facilities must be prepared to identify high costs, high utilization, and low quality issues before they occur.

The United States spends almost 50% more on healthcare than the next-highest country. In fact, the U.S. spends more on healthcare yet has lower life expectancies, and worse health outcomes, than any other high income nation.

When the rising costs of healthcare are considered, a primary concern to providers, patients, and their health insurance payers is the security in knowing that systems are in place to insure effective, efficient, and sound delivery of care.

With particular emphasis on behavioral healthcare clients, the overwhelming majority have co-occurring disorders and receive healthcare and treatment from a variety of practitioners and professionals. The integration of all levels of provider services, while necessary and beneficial, could potentially create areas for risk with regard to patient information transfer and professional collaboration. It is important for providers to focus on the integration of their client’s treatment and healthcare services and to ensure that all aspects of a patient’s healthcare plan are in alignment with best practice methodologies.

As the field continues to evolve, providers will need to be prepared to mitigate clinical risks including the potential for psychographic data risk and care plan vulnerabilities.

Risk Management on the MAP Platform

MAP’s Platform offers your facility the ability to identify, evaluate and monitor, and ultimately prepare for any potential risks to your organization including the potential for healthcare (patient) episode clinical risks such as relapse or a use event which could include increased costs of care due to the necessity for additional care and intervention.

Behavioral healthcare risk management is critical to your operation, particularly at a time when reimbursements are scrutinized and patients have begun to increasingly compare healthcare services.

Providers must be prepared for the changing landscape of healthcare and a key component to effective population health management is risk management.

MAP’s Platform will provide you with programs to Predict, Prevent and Prepare for risks.

With MAP’s Risk Management program, you will be able to:

  • Identify potential risks to your specific facility.
  • Identify potential risks to your patients care plan including relapse, use event or a return to unhealthy choices and behaviors due to the manifestation and symptomology of their disease.
  • Establish and maintain a policy for planning and performing the risk management process.
  • Demonstrate that your facility has a process to determine risk sources with facility-specific categories that help to determine relative priority.
  • Effectively define the parameters required to analyze and monitor risks specific to your facility, your operations, and your patients.
  • Process and document an episode or event should it occur.
  • Demonstrate that your facility reviews the activities and status of the risk management process with high-level management to resolve issues.
  • Demonstrate that you objectively evaluate adherence of the risk management process against its process description, standards, and procedures with actionable steps to address non-compliance.

Healthcare costs must be contained and risk management has become a high priority for leading behavioral healthcare organizations and treatment facilities. The MAP Recovery Network Platform provides you with the resources you need.