Effective Case Management is the key to cost containment on high-risk participants.

As Critique keeps high-risk participants out of the hospital you may find, Critique electronically monitors health readings in real-time; among others, blood sugar levels and blood pressure readings are immediately received.

What’s important about that? As you work with Critique you may find Critique provides oversight and coordination of all doctors, hospital, prescriptions and personal activities to optimize care and decrease cost.

Critique applies high-touch Case Management which naturally reduces costs and helps participants.

Nurse coordinators manage the delivery of medical services during the acute phase of the illness or injury. Discharge planning may include assisting the patient, physician and family to arrange transfer to an appropriate high-quality facility or home care. These coordinators have extensive knowledge of local and regional centers for specialized care, volunteer organizations, and other resources available that can maximize options and minimize complications. Each case may require the nurse to negotiate rates where appropriate and manage the care in coordination with:

• The patient
• The patient’s family
• The attending physician
• The hospital
• Home health care agencies
• Hospice
• Social service agencies
• Durable medical equipment vendors
• Placement of telemonitor equipment

Weekly multi-disciplinary review is performed, as appropriate, to obtain input and to discuss cases relative to medical plan benefits.