Managed Care

“Decades of research have demonstrated that economic stability, physical environment, education, food, and social context are powerful upstream factors that largely determine one’s health before the health system is able to intervene.”

Social Determinants As Public Goods: A New Approach to Financing Key Investments In Healthy Communities,
August, 2018 Health Affairs

There is increasing interest in placing vulnerable populations (such as individuals with intellectual/developmental disabilities, children in foster care, the previously incarcerated) who were traditionally served by government through contracts with community based providers into managed care plans.

A recent study shows that non-medical factors such as economic instability, housing insecurity and unsafe neighborhoods impact 40% of patients’ health outcomes. If insurers and health systems are accepting financial risk for patients’ health, how do they manage the non-medical factors that drive the health outcomes?

The Fedcap Group offers programs that address the non-medical issues affecting patients’ health by:

  • directly offering educational, workforce and social programs; and
  • establishing accountable networks of social services agencies and actively managing patients’ social needs.

Working with insurers and health care organizations, we provide patients access to the services and supports that allow them to focus on their health.

The challenge for insurers and providers who are responsible for patients’ health is how to engage patients distracted by the other issues they face?  The Fedcap Group knows how to engage the hard-to-engage patient and are effective in help payers assess and manage the risks associated with providing care in a managed care environment.

The Fedcap Group has the expertise and capacity to be a reliable partner to help reduce hospitalization and readmission. We work with populations facing challenges that make them hard to engage, such as behavioral health issues, substance use disorders, chronic health conditions, intellectual and developmental disabilities and diverse cultural backgrounds. Our network of top tier agencies can help by pinpointing needs and planning effective interventions.

The Fedcap Group is a strong partner that assists payers to manage the risk of working with individuals who are often noncompliant with traditional medical care plans.

For more information contact Robin Fisk Rfisk@fedcap.org.