Iselin, New Jersey, May 1, 2006 – Building Service 32BJ Health Fund (the Fund), which provides benefits for the largest building service workers union in the country representing more than 85,000 members, implemented the latest release of RightPath Navigator (RPNavigator) to support the organization’s program design, medical management, and program measurement initiatives.
“RPNavigator allows us to quickly understand the underlying root causes of our medical cost trends, and provides us with the information we need to proactively manage our health care expenditures. We have become smarter managers of our population’s health care needs, and are able to increase the focus on the quality of care we provide to our members and their dependents,” said Angelo Dascoli, Health Fund Director. “Our team has been successful in moderating cost and disease trends and growing reserves, and we will continue to aggressively pursue those means through the use of technology. CareAdvantage’s RPNavigator is an important component of our efforts.”
RPNavigator integrates financial, medical, pharmacy, and other data elements to provide a clear picture of the disease burden and projected cost trends of the covered population. 32BJ Health Fund is leveraging these capabilities to design and implement a disease management program, and to generate reports to support medical management and audit functions.
“The system is versatile and provides us with an in-depth analysis of our members’ experience and needs. For example, RPNavigator allows us to check medication compliance which may be required by our pre-certification policies for certain surgical procedures. The system also allows us to closely look at physician and hospital performance. We can check for quality and outcomes and use the data to help us understand our plan design needs. We also intend to use the cohort analysis function to measure the program performance and performance guarantees of our contracted disease management vendors. In this way, we have an independent assessment our the program’s success,” said Gail Wilder MD, Esq., Medical Director at 32BJ Health Fund.
RPNavigator was originally developed to support CareAdvantage’s cost containment services, including utilization review, case management, and disease management. CareAdvantage utilizes several methodologies developed by 3M Health Information Systems including; Clinical Risk Groups (CRGs), All Patient Refined DRGs (APR-DRGs), and Ambulatory Payment Groups (APGs).
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