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Healthways Senior Care Management

A Powerful, Targeted Solution That Can GuaranteeReductions in Medicare Costs

As reimbursement decreases and medical costs rise, Medicare Advantage

Plans are increasingly challenged to nd new approaches for reducing costs,

including reducing demand for preventable high-cost events.

Healthways Senior Care Management (SCM) is a next generation total

population management solution that uses a series of powerful, proprietary

predictive models to more accurately identify Medicare members within your

plan who are at highest risk of having a high-cost event in the near future. We

then use highly targeted, personalized, proven interventions to prevent many

of these events from occurring.

Our highly dynamic, predictive models enable us to accurately focus in on

only those select individuals with whom we can most eectively intervene to

reduce risks and avert preventable emergency room visits, hospitalizations, and

hospital readmissions. Because we expend resources only where we can have

the greatest impact on outcomes, we optimize your opportunities for short-

term cost savings. Result — your plan will achieve signicant ROI within one

year of the program.* We can guarantee it.

Our proprietary and unique approach is shaped by nearly 30 years of care

management experience, 15 years of health management experience, and

more than 50 million member months of proven engagement and interventionwith aging and chronically ill individuals. More than 6 million members of 

Medicare Advantage Health Plans, Medicare Supplemental Carriers, and

Medicare fee-for-service condition management plans already have access

to Healthways programs. All Healthways programs are accredited by URAC

and NCQA.

healThwayS Senior Care managemenT

To learn more about how Healthways Senior Care Management

Solution can help you achieve your goals, visit www.healthways.com.

Healthways Senior Care ManagementSolution reduces risks, lowers costs

and can guarantee ROI within your

Medicare population in the rst year.

Improves ConnectivityHealthways connects with 75%of the targeted SCM population.

Reduces Risks and AvoidableUtilization

• Reduces targeted admits*

• Reduces targeted re-admits*

Achieves ROI

• Delivers signicant rst year ROIthat Healthways can guarantee*

• Can be integrated with Healthways’SilverSneakers Fitness Program, thenation’s leading exercise program

for older adults, to generateadditional ROI opportunities.

• End of Life Model: Uses a neural network to predict the likelihood of 

members entering the end of life process.

• Cost De-escalation Model: Identies and separates individuals whose

expenses are expected to decline without intervention.

• Future High Cost Model: Identies members most likely to incur high

costs in the next 12 months.

• Clinical Risk Model: Identies highest probable number of mitigable

clinical risks and gaps in care.

SIOR CAR MAAGMT PRICTI MOS:

*Results will vary, based on your plan’s population and other factors.