ActiveHealth's Patented CareEngine(R) System to Compare Evidence-Based Medical Standards Against Members' Medical Claims to Improve the Quality of Health Care for State Employees and Lower Medical Costs
February 1, 2006 - ActiveHealth(R) (Active Health Management, Inc.), a technology driven, clinically based health management services company, has been awarded a contract from the State of South Carolina to provide CareEngine(R) clinical decision support services to the State's public employees and their dependents. Under the two-year agreement, effective February 1, 2006, ActiveHealth will cover more than 340,000 members of the State's Health Plan through its proprietary CareEngine technology. BlueCross Blue Shield of South Carolina, which administers the plan for the State, will work with ActiveHealth in this program, providing historical and ongoing data from medical claims. In addition, in light of the plan's longstanding relationships with providers in the State, BlueCross BlueShield of South Carolina will play a key role in provider relations efforts.
"We look forward to introducing this program to our members, as an effort to improve care while helping to keep rising health care costs in check," stated Rob Tester, Director of State of South Carolina's Heath Plan.
Designed to improve the quality of health care and thereby reduce medical costs, ActiveHealth's CareEngine continuously compiles medical, pharmacy and laboratory claims data from members and scans this information for clinical issues. At the same time, a dedicated team of physicians and pharmacists reviews the latest evidence-based medical literature. The CareEngine analyzes this claims data against accepted medical standards and issues patient-specific clinical alerts, called Care Considerations, when an opportunity to improve care, avoid a "gap in care" or prevent a medical error is discovered. Care Considerations are sent via phone, fax or mail to the treating physician to help prevent avoidable clinical complications and unnecessary hospitalizations, and include specific references to medical literature. Once issued, the physician reviews the Care Consideration and applies his or her clinical judgment and knowledge of the patient to determine if and how to alter treatment. The CareEngine has been proven to significantly improve clinical outcomes, reduce medical errors and lower health care costs. The CareEngine currently covers more than 10 million members.
In a fragmented health care system that is becoming increasingly complex and data-intensive, physicians must rely on technology to stay current on matters such as recent clinical trials, new pharmaceuticals, evolving clinical procedures and newly developed medical devices. "The CareEngine System was developed by physicians to support physicians. It enhances communications between the doctor and patient with highly specific, targeted information that facilitates smarter, more informed decisions about the member's treatment," said Lonny Reisman, MD, CEO of ActiveHealth. "Our CareEngine platform has already communicated thousands of opportunities for care improvement to physicians and patients. We are a clinical and technology resource, helping physicians and patients to more closely adhere to accepted medical standards as a means of guiding sound treatment decisions," he added.
BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association.
About State of South Carolina EIP
The State of South Carolina Employee Insurance Program (EIP) offers several insurance products and programs, including health, dental and life insurance, long-term disability, long-term care, flexible spending accounts, and vision care discounts. More than 415,000 people (including spouses and dependants) throughout South Carolina are insured through one of the health plans offered by EIP. More than 178,000 of these are active employees, and more than 53,000 are retirees.
The EIP is part of the South Carolina Budget and Control Board, the central administrative agency for South Carolina state government. The Board performs a variety of functions that assist state and local agencies and employees in carrying out their missions. Its duties include operating the state retirement, procurement, liability insurance and fleet systems. The Board is overseen by a five-member body chaired by the Governor. This body selects the Budget and Control Board's Executive Director, who serves as the agency's chief administrative officer.
About ActiveHealth Management
ActiveHealth Management is a technology-driven health management and data analytics company engaged by leading health plans, employers and government payors to help improve care for those most in need, prevent medical errors and reduce medical costs. Over 10 million patients nationwide have benefited from programs powered by ActiveHealth's patented CareEngine(R) System.
ActiveHealth offers CareEngine Clinical Decision Support, Informed Care Management and customized programs, complemented by a full range of care management services, including case identification, case management and utilization management. The company's HDMS - Health Data Management Solutions - business provides data analytics and consulting services for payors, providers, and suppliers nationwide.
Founded in 1998, ActiveHealth Management is headquartered in New York City with offices in Cleveland, Chicago, and Chantilly, Virginia. For more information, please visit
www.activehealth.net.
ActiveHealth(R) and CareEngine(R) are registered marks of Active Health Management, Inc.
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