Harmony Care Management Mary Hughes Sue Eickelkamp Christina Salm

What is Harmony? Member-centric approach to medical management Personal touch, establishes trusting relationships View the member holistically to guide them to the best possible care

The Harmony Spectrum of Care

Spotlight: Utilization Management Why perform Utilization Management? Safety of our members Only appropriate care provided Right setting, Right price Help keep the cost of premium down “Free Second Opinion”

Example: Sleep Studies What yields better results for the member? Sleep Studies done in the home or in a sleep clinic?

How Does Harmony Compare?

A Medical General Contractor Our competitors traditional DM program focuses on one disease, like hypertension or diabetes. One nurse focuses on these “disease states” and this nurse maybe classified as a specialist but really how special is it to only know a lot about such a narrow scope of topics. It would be like hiring an electrician to remodel your entire home or kitchen. Would you trust them? Are they going to know how to do plumbing and flooring? Probably not.

Member Identification Here is a view to better understand how some of the analytics will work. If we think of a funnel, we would first funnel high inpatient/ER users to help us with a starting point. M

Harmony Nurse Spotlight

Christina Salm – Harmony Nurse Christina is responsible for developing and communicating recommendations for enhancing the Harmony Care Management program to ensure the program meets the needs of members. With 20 years of nursing experience Christina has had the honor to work with patients and health care providers in many areas including  Trauma and Life Support, Medical/Surgical, Case Management, Hospice, Home Health, and Insurance Operations. Christina Shares a Story!