Discover How AHCP’s Products and Approach
to Healthcare Management will benefit:

  • Employers
  • Physicians
  • Brokers
  • Consultants
  • Members

Choose from 3 separate products that offer
unique management features, population-
specific data, proven chronic disease management
practices and lifestyle education.

AHCP Product Descriptions

Health Advisory Product
This product includes a semi-annual and annual health plan analysis and written information on wellness, prevention, lifestyle issues, and chronic diseases to both members and providers, where appropriate.

Health Advocacy Plan
This is the comprehensive health management program as described above, the Health Advisory information, and active nurse to member and provider interaction.

Traditional Utilization Management
This product provides the traditional managed care services of pre-certification, utilization review, and large case management. This is offered with the Comprehensive Health Management program or can be purchased as a freestanding product. AHCP encourages groups utilizing its comprehensive Health Management Program to consider using our UM program, as it has a synergistic effect.

Why Choose American Health Care Partnership?

 
 
 
 

Our Products and Services

AHCP operates all its programs around holistic, population-specific Health Teams comprised of a nurse and a service support associate. Each Health Team nurse is responsible for all components of the comprehensive health management program, from wellness and prevention to disease and large case management. This way, there is continuity of care and the Health Teams become well versed in its populations’ inherent and specific health issues. The Health Team approach also fosters interpersonal relationships, ownership, and responsibility.

Scope of Services: Hands On Approach
The AHCP Health Team interacts with its members on-site during enrollment, clinical lab screenings, and quarterly visits to the place of business. On-going, telephonic and electronic messaging relationships are developed with the members and providers of members with chronic diseases and those members who wish to address a lifestyle issue.

Diseases Managed
Obesity, Diabetes (and this includes all complications associated with this disease), Hypertension, Coronary Artery Disease, Congestive Heart Failure, Hyperlipidemia, and COPD.

Identification
AHCP uses a number of tools to identify, stratify, and interact with members. A three page, clinically focused, Health Risk Assessment form is used to stratify members with diseases or lifestyle issues, and quantify risk. Claims data is monitored weekly to identify members newly diagnosed with a disease or complication. Clinical lab values are used to monitor disease control.

These tools allow the Health Team to monitor the care management provided by clinicians. AHCP represents three value added services to members’ physicians, thereby increasing patient and provider compliance:

  1. The Health Teams help physicians identify gaps in coverage for patients with chronic disease.
     
  2. The Health Teams provide assistance to physicians and their staffs for the education of patients with chronic disease, increasing self-management skills.
     
  3. The Health Teams provide assistance in increasing the compliance of patients for medication usage, keeping appointments, and following doctors’ treatment recommendations.
     

Stratification of Population’s Health
By use of demographics, the Health Risk Assessment, and claims data, the adult beneficiaries are stratified into one of three categories:

Category 1: Good Health: No missing prevention testing, no lifestyle issues, and no chronic disease. The system is flagged to assure the member remains up to date with their prevention parameters.

Category 2: The individual is lacking in a prevention parameter or early detection test. In addition, the individual may have one of the following lifestyle issues that have been shown to increase the chance of developing a costly disease: smoking, lack of exercise, or being overweight.

Category 3: Any of the above, plus has one or more of nine diseases that AHCP actively manages.