SOURCE: American Health Holding, Inc.

July 19, 2005 09:39 ET

American Health Fulfills Important Component of Successful Health Plans

COLUMBUS, OH -- (MARKET WIRE) -- July 19, 2005 -- According to a recent white paper released by the Self-Insurance Institute of America (SIIA), the key to a self-funded health plan's success is its ability to make an impact on utilization and cost. The white paper, titled "A Model Self-Funded Health Plan," goes on to list the health care management programs that make such an impact, stating that "each is an important component of a sound health benefits plan": Utilization Management, Case Management, Disease Management, Predictive Modeling, and Population Management.

American Health understands the vital role it plays in the management of costs and utilization, and is committed to reducing healthcare costs while improving quality of care. They offer each of the programs sited by SIIA as being integral components in a benefits plan.

Using proprietary, nationally recognized criteria, American Health's Utilization Management program provides determinations for in- and outpatient procedures and services. It reduces costs by ensuring that treatments being provided are medically necessary.

American Health's Case Management program positions specialty RN Case Managers as educators, liaisons, and negotiators, improving care and managing costs while ensuring that patients understand their conditions and care options.

The Beyond Disease Management program is geared toward high-risk, high-cost members. Care Managers create patient-specific care plans using evidence-based guidelines, and encourage patients to become active participants in their health care, empowering them to make necessary lifestyle changes to reduce their health risks. The program includes access to Care Line, American Health's 24/7 nurse line and health information library.

A predictive modeling tool is integrated into American Health's Beyond Disease Management program. The resulting predictions incorporate clinical factors and risk markers to identify potentially high-risk individuals specific to each client's population. Individuals identified as having high potential utilization and costs are referred to Beyond Disease Management as potential enrollees.

To fulfill the Population Management component, American Health offers Care Line and Health-e Outlook. While Care Line provides triage and health information via telephone, Health-e Outlook is a web-based program providing a wealth of wellness and health tools, including an online Health Risk Appraisal, health managers, and a customizable health dashboard. Both programs educate members to be more informed consumers of health care.

ABOUT AMERICAN HEALTH HOLDING, INC.: Founded in 1993, American Health is a full-service medical management firm. They offer services that span the healthcare continuum, including Utilization and Case Management, Care Line (24/7 demand management), Out-of-Network Discounts, Referral Authorization, Health-e Outlook (wellness web portal), Tomorrow's Child (maternity management) and the Beyond Disease Management program. American Health holds multiple URAC accreditations. For further information about American Health Holding, visit the website:

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