What we do does not define us
Characterization of the population.
Risk classification.
Evaluate type of treatment and therapeutic management.
Educate the patient, his family and responsible health personnel.
Evaluate results.
Analysis of the current state and establishment of gaps.
Scientific technical financing and management model, adapted to the reality of each EPS, for the implementation or use of the route.
Deployment, socialization and implementation of comprehensive care models and routes.
We offer our capacity and technical knowledge to perform an analysis of the offer in secondary sources of information such as: REPS, SISPRO, RETHUS, and other sources of Information that allow knowing the availability of the offer of the Service Provision Network; Installed capacity and authorization of health services.
We have evaluation boards for the technical – scientific and technical – administrative criteria for the selection of providers by region and concentration, according to the needs of population Characterization and segmented Risk Groups.
We have the knowledge and our work team has the skills to design and apply a SCORING that allows us to select the providers required for the integration of our clients’ network of services; according to scores obtained from the Offer Characterization versus the provider selection criteria panel.
We make our technical knowledge available to carry out work tables with providers; apply contractual pre-selection documents, based on confidentiality agreements, confidentiality of information, and strict compliance with good governance policies, to execute with total suitability, objectivity and transparency the selection and evaluation processes of health service providers , applying legal and administrative criteria; framed in the current regulations of the Colombian Health System; guided by control tools in the areas of Procurement and Compliance.
Actuarial analysis of rates and modeling of criteria according to authorized services, value offer, installed capacity, network sufficiency and type of contract. Construction of the pricing models and the actuarial technical note to support the health care planning processes, health contracting; and actuarial risk management, by type of services; risk groups and cohorts; levels of care and geographic dispersion.
Value-Based Health Care / Component “INTEGRATED CLINICAL UNITS”
The INTEGRATED CLINICAL UNITS are work teams of clinical and non-clinical staff that provide services to the patient throughout the care cycle, generally organized by pathologies, not by specialties or physical spaces.
Measurement of Results and Costs for each patient / Component “PAYMENTS FOR COMPREHENSIVE CARE PACKAGES
In the generation of value, results measurements must be constructed, both from the clinical perspective and from the patient’s perspective, maintaining a permanent correlation with the information related to costs.
The value chain should focus on payments for comprehensive care packages or also called grouped payments, in which the total cost of a health outcome is calculated and in the case of over-costs due to readmissions or adverse effects; as well as the generation of incentives for organizations oriented towards a culture of value.
Integrated Health Service Delivery Networks / Geographic Expansion
Health care mus avoid duplication of resources by creating integrated networks, which should be build through:
- The redefinition of the range of Service Offered.
- The calculation and estimation of the Offer from the demand (real and expected).
- The selection of the correct location of health services by scope of care, geographic scope and resolution.
- The integration of the process through specialized networks that allow improving the application of standardized clinical practice guidelines, protocols, checklists and quality monitoring processes.
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