Intus Care Announces Availability of Delegated Utilization Management Service for PACE
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August 20, 2024, Providence, RI – Intus Care, a pioneer in advanced software and data-driven solutions for geriatric healthcare, today announced the availability of Delegated Utilization Management (UM) services for Programs of All-Inclusive Care for the Elderly (PACE), a first-of-its-kind fractionally-staffed Integrated Care Services (ICS) clinicians and nurses who optimize utilization management for organizations.
Intus Care’s technology is the first to specialize for PACE organizations, incorporating proprietary data models and integrating data from other applications to help seniors get the care they need to remain in their homes and communities. The company also supports PACE through its Integrated Care Services team, which provides expertise to partner programs. Intus Care currently supports over 50 PACE organizations through its software and services.
Utilization management is critical for PACE organizations to keep participants healthy while also controlling costs by ensuring that participants receive the right care at the right time in the right place. Some key measures of UM include reduction of unnecessary trips to the emergency department (ED) or hospitalizations. Chief Population Health Officer Laura Ferrara looks at UM as “a three-legged stool where access to care, quality of care, and alignment of care with personal values should all be equally important with PACE programs.”
Intus Care has a team of PACE experts on its Integrated Care Services team who can support programs across a variety of measures from compliance to quality as well as UM, using a data-driven approach to uncover utilization trends and opportunities for improvement. Now, Intus Care will offer a service specific to UM through fractionally-staff clinicians and nurses. This allows PACE organizations to have an expert in utilization management that knows how to navigate the function and work within the PACE model of care and support the organization at a high level.
The delegated UM service will enable authorization and payment processes, network management, and Interdisciplinary Team (IDT) UM workflows to address preventable utilization directly and with the ability to scale. The professional UM nurse will work with a PACE organization’s team on:
- Developing or refining the UM infrastructure,
- Ensuring access to timely and critical data to measure the right outcomes at the point of care, and
- Managing the UM process including systemizing authorization and claims payment processes.
The expert will collaborate with leadership, IDT and clinical staff, operations, and finance to ensure all are working together for effective UM.
“Proactive utilization management is crucial to achieving the best outcomes for older adults in PACE programs. By focusing on prevention, early intervention, and coordinated care, we can improve the quality of life for participants while effectively managing costs,” said Ferrara. “Through this new Delegated Utilization Management offering, we can tailor the role to the program’s needs, working closely with the PACE program to tailor the UM expert to their organizational structure and into their relationships with hospitals and skilled nursing facilities. The utilization management clinician or nurse is embedded within the PACE interdisciplinary team, aiming to set the standard for high-quality care and support for older adults.”
Current customers who are interested in Delegated Utilization Management services can contact Intus Care through the website or directly through the Intus Care platform.
About Intus Care
Intus Care empowers PACE organizations nationwide through automated software and PACE expert consulting. Our PACE-focused analytics platform improves clinical decision-making and data accessibility, while our Integrated Care Service experts collaborate with programs to improve Compliance, Quality, Utilization, and more through a hands-on, data-driven approach.
Intus Care currently works with over 50 PACE programs across 16 states and closed a $14.1M Series A in Q4 of 2022.
Visit our website to learn more intuscare.com.
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