 Changing Healthcare.

Traditional Management Approach

 Many programs available focused on proper utilization and improving the
quality of care
 Programs tend to be fragmented with little to no collaboration

Chronic Medication
Acute Care Utilization Mental Health
Disease Therapy
Management Review Management
Management Management
Why Integrate?
 Patient care is complex. Integration unites different viewpoints and allows
management of every aspect of patient care.

NURSE CARE PHARMACIST CARE

MANAGER MANAGER MENTAL
HEALTH CARE
Supports and advocates for
Approaches care from a MANAGER
patients helping them
treatment based
navigate the health care
perspective focused on
system and obtain Incorporate social and
disease and drug
appropriate care behavioral
information
components of care
EMI Health’s VCM Program
 Integrates programs across the care
continuum
 Collaborative team approach
 Pharmacists
Pharmacist
 Nurse Case Managers Mental
 Mental Health Specialist
 Providers Nurse Health
Patient
 Simplifies care for patients
 Coordination with plan benefit
 Integrated with operations Doctor
Caregiver
 Aligned with plan goals
 Coordinates care back to the clinic providers
Population Health Management
 Data Utilized

Medical Claims PreAuth Reports Pharmacy Claims

 Case Management  Utilization Review  Medication

 Disease Management  Case Management Therapy
 Mental Health  Mental Health Management

VCM
EMI Health’s VCM Diagnoses
 Case Management  Transitions of Care  Disease Management
 Cancer  Asthma and COPD  Asthma and COPD
 High risk pregnancy  Behavioral health Pharmacist
 Depression
 Pain management  Stroke  CongestiveMental
Heart Failure
 Transplants Nurse  Stroke Health
 Congestive heart failure
 Large claims  Diabetes  Diabetes
 Multiple ER visits  Heart disease  Heart disease
 Readmissions Doctor
 Hypertension
Caregiver
 Kidney disease
For additional questions or to enroll in these services
please call: 801-433-6232 or 855-586-2575