QuadMed, WPS partner to launch innovative health care option

Sussex-based QuadMed and Madison-based WPS Health Insurance announced today the launch of Intellicare, a combined solution to help businesses improve their employees’ access to high-quality, cost-effective health care focused on positive outcomes.

As employers look for appropriately priced health plans in the era of The Affordable Care Act, QuadMed and WPS believe Wisconsin employers need alternative options. The organizations are working together to create a new model of care that they say can’t be found in traditional plans or onsite clinic offerings. This model eliminates the need for multiple vendors by offering primary care and insurance coverage in one solution.

The model includes QuadMed’s on-site, near-site and shared site clinic services and may also include access to third party 24/7 telehealth services, complemented by third-party administration and insurance solutions through WPS. The health care delivery of QuadMed combined with the health plan administration of WPS is said to create powerful synergies to give employers a quality, convenient, cost-effective new choice in health care.

The goal of Intellicare is to improve employee health while controlling costs for employers and employees. Its approach is based on the following key points:

•    Focus on primary care, prevention and wellness.
•    High-value referral system that identifies the best specialty providers and offers scheduling assistance for patients.
•    The use of data to improve diagnoses, treatments and outcomes.
•    Identification of at-risk patients, helping them take better control of their health before a condition worsens and becomes more expensive to treat.
•    Superior customer service and claims processing, including a dedicated customer service consultant as a single point of contact for the employer.
•    Customized plan options and reporting to improve overall employee health and cost management.

“Intellicare is the result of an innovative idea born out of necessity at a time when the national conversation on health care delivery is becoming increasingly complex,” said Mike Hamerlik, WPS president and chief executive officer. “Facing many of the same challenges from rising health care costs as other businesses, WPS partnered with QuadMed several years ago to create a better way to offer health care to our employees. Intellicare is the result of the success we had from our collaboration. It’s a proven solution.”

“Quality, cost-effective health care is essential for us all,” said Sue Buettner, QuadMed president. “Our approach, which is predicated on a close relationship between the primary care provider and patient, makes it easier for individuals to take ownership of their health and overall wellness. We are excited about this innovative solution with WPS so we can expand our progressive model to more people throughout the state.”

The organizations say Intellicare promotes shared decision-making, combining scientific evidence with the patient’s values and preferences while empowering the patient to make a truly informed decision.

For care that requires specialization not available within the clinic, Intellicare offers high-value referrals. QuadMed providers identify specialists offering the greatest level of care and value to the patient regardless of health system or affiliation.

WPS and QuadMed each use analytics to help identify high-risk people and enable health intervention before individuals become high-cost patients.

Intellicare is intended to save clients’ money by promoting better care utilizing a patient-centered medical home model. Intellicare also helps effectively manage referrals and uses cost and quality parameters to identify the most appropriate specialty providers. Finally, patient care is reportedly better managed by offering primary care in addition to wellness programming with a focus on chronic conditions.

For more information, fully insured or self-funded employers may contact a local WPS agent or call 800-268-0048.

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