welcomed teamwork
SHPS case management is a collaborative effort, where personal nurse advocates work with participants to coordinate, educate and counsel them on the appropriate care during acute health crises. It includes advocacy, communication and resource management – promoting quality, lowering costs and improving outcomes. SHPS programs target nearly 40 different conditions – alleviating high costs, further healthcare disability and the frustration often associated with these events.

empowerment rather than feeling powerless
Health crises can come without warning and take a devastating toll – medically, financially and psychologically. Rather than feeling powerless, SHPS case management helps participants regain a sense of control over their healthcare. Our dedicated nurse advocates offer a sense of trust and support as they navigate different benefits, providers and procedures. After seeing the control they do have over their healthcare – even during a crisis – participants carry this consumer mindset forward. And as more of your customers adopt consumer-driven health strategies, providing this service will be crucial. Partnering with SHPS links our experience in case management with our clinical, financial and communication expertise – giving your customers a seamless, high-quality solution.

targeted, comprehensive care
SHPS case management is a market leader in identification via health claims, ensuring that participants are reached in time to achieve significant savings and improved health. Whereas many competitors target via pre-authorization phone calls, SHPS case management leverages a sophisticated rules-based system to identify at-risk participants, stratify them using more than 7,500 clinical rules and provide targeted interventions based on their unique risk profile.

SHPS case management offers our partners:

• speed-to-market. By partnering with SHPS, you’ll quickly close the case management gap in your care management portfolio – bringing our best-in-class solution to bear in helping your acute-care members.
  
  
• advanced identification and stratification. Our extensive rules-based system, along with standard referrals, allows us to quickly reach out to more at-risk participants than competitors. And with our advanced stratification method that accounts for thousands of clinical parameters, we can create a robust risk profile to guide appropriate interventions.
  
  
• superior engagement and enrollment. We utilize behavior modification models and psychological techniques that make our program engaging and effective, increasing the likelihood that identified candidates will opt-in to participate in the program. And multi-media enrollment campaigns allow us to reach out and engage more people in diverse ways.
  
  
• personalized interventions. Our personal nurse advocates work one-on-one with participants to create individualized plans and goals. These nurses have clinical expertise with the participant’s condition, and utilize more than 125 proprietary clinical protocols based on evidence-based medical guidelines to assist them.
  
  
• cost savings and care coordination. SHPS case management can reduce utilization costs, offer negotiated savings and coordinate other health and benefit administration offerings – whether offered by your organization, SHPS or an outside vendor. Cost savings from effectively managing and de-escalating these health crises are often significant.
  
  
• improved outcomes. Participants can reduce or avoid hospitalizations, prevent health complications and lower their overall health risks. And they are more likely to comply with treatments and evidence-based care guidelines proven to improve health outcomes.
  
  
• seamless, personalized experiences. SHPS offers a wide range of health and benefit programs that can complement our case management program, so participants receive optimal medical management through a seamless process. Our flexibility also allows for integration with outside programs and benefits, including your existing care management portfolio.