BENEFITS RISK MANAGEMENT
RISK MANAGEMENT
Turning data into actionable intelligence and effective risk management strategies
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Cost Containment Strategies are the Core of the Most Sustainable Health Plans
Access to Data
Access to data opens up a world of possibilities and strategies in order to achieve our benefit objectives. The following are just some of the strategies
▪ Integrated Healthcare Risk Management
▪ Effective Wellness Program Initiatives
▪ Chronic Disease Management
▪ Claim Analytics, Predictive Modeling & Trend Analysis
▪ Value-Based Health Management
▪ Healthcare Transparency Tools & Resources
▪ Cost-Effective Pharmacy Benefit Managers (PBM)
▪ International Pharmacy Solutions
What Happens When You Manage Risk
In addition to an effective wellness program, another critical component to controlling costs includes a targeted process in managing claims. Christi has partnered with one of the most proven claims management vendors in our market for over a decade.
Together, our process includes identifying chronic conditions in a population through medical benefit claims or self-identification utilizing a Health Risk Assessment. Healthcare Navigator™ Nurses are trained in Motivational Interviewing to coach those identified with any of the 27 conditions that we track. Our goal is long term behavioral change to improve patient self-management.
The most recent evaluation of the financial effectiveness of the program has been accepted for publication in a peer-reviewed medical journal and is available upon request. This evaluation indicates a reduction in cost of about 14% compared to what would be expected, given all of the members’ medical conditions.
Chronic Disease Management
Our Chronic Disease Management program is designed to drive long-term behavioral change and empower individuals to take control of their health. By focusing on improved patient self-management, we help reduce the burden of chronic conditions across your workforce.
This results in lower healthcare claims costs—driven by early intervention, sustained engagement, and improved health outcomes. Program effectiveness depends on the prevalence of chronic conditions in your population and the level of employer support for participation and ongoing engagement.
Acute Illness Management
Health challenges can arise at any time, varying widely in severity and complexity. While many conditions are minor and short-term, others fall into more serious categories—either chronic conditions requiring lifelong care, or acute illnesses that appear suddenly and may demand urgent, intensive intervention.
Acute illnesses range from the common cold to more serious events such as trauma from accidents or complications from other diagnoses. Our Acute Illness Management (A.I.M.) program focuses on identifying individuals experiencing severe acute episodes, defined as cases with a Predicted Allowed Amount of $25,000 or more.
Once identified, these individuals receive personalized outreach from our Registered Nurse Navigators and Case Managers.
Utilization Review & Case Management
Utilization Review is a critical component of effective care management, ensuring medical necessity and plan compliance. Case Management identifies members facing complex, high-cost, or catastrophic health events.
Through proactive identification, our Case Managers provide personalized support, helping patients navigate their care journey while optimizing outcomes and controlling costs.
The Result.
The result is the ability to achieve excellence and implement new innovations into your health care program. Christi opens the door for employers to improve performance, implement value-based solutions and achieve real results for their organization and improve the quality of life of their employees.
Access to data opens up a world of possibilities and strategies in order to achieve our benefit objectives. The following are just some of the strategies
▪ Integrated Healthcare Risk Management
▪ Effective Wellness Program Initiatives
▪ Chronic Disease Management
▪ Claim Analytics, Predictive Modeling & Trend Analysis
▪ Value-Based Health Management
▪ Healthcare Transparency Tools & Resources
▪ Cost-Effective Pharmacy Benefit Managers (PBM)
▪ International Pharmacy Solutions
What Happens When You Manage Risk
In addition to an effective wellness program, another critical component to controlling costs includes a targeted process in managing claims. Christi has partnered with one of the most proven claims management vendors in our market for over a decade.
Together, our process includes identifying chronic conditions in a population through medical benefit claims or self-identification utilizing a Health Risk Assessment. Healthcare Navigator™ Nurses are trained in Motivational Interviewing to coach those identified with any of the 27 conditions that we track. Our goal is long term behavioral change to improve patient self-management.
The most recent evaluation of the financial effectiveness of the program has been accepted for publication in a peer-reviewed medical journal and is available upon request. This evaluation indicates a reduction in cost of about 14% compared to what would be expected, given all of the members’ medical conditions.
Chronic Disease Management
Our Chronic Disease Management program is designed to drive long-term behavioral change and empower individuals to take control of their health. By focusing on improved patient self-management, we help reduce the burden of chronic conditions across your workforce.
This results in lower healthcare claims costs—driven by early intervention, sustained engagement, and improved health outcomes. Program effectiveness depends on the prevalence of chronic conditions in your population and the level of employer support for participation and ongoing engagement.
Acute Illness Management
Health challenges can arise at any time, varying widely in severity and complexity. While many conditions are minor and short-term, others fall into more serious categories—either chronic conditions requiring lifelong care, or acute illnesses that appear suddenly and may demand urgent, intensive intervention.
Acute illnesses range from the common cold to more serious events such as trauma from accidents or complications from other diagnoses. Our Acute Illness Management (A.I.M.) program focuses on identifying individuals experiencing severe acute episodes, defined as cases with a Predicted Allowed Amount of $25,000 or more.
Once identified, these individuals receive personalized outreach from our Registered Nurse Navigators and Case Managers.
Utilization Review & Case Management
Utilization Review is a critical component of effective care management, ensuring medical necessity and plan compliance. Case Management identifies members facing complex, high-cost, or catastrophic health events.
Through proactive identification, our Case Managers provide personalized support, helping patients navigate their care journey while optimizing outcomes and controlling costs.
The Result.
The result is the ability to achieve excellence and implement new innovations into your health care program. Christi opens the door for employers to improve performance, implement value-based solutions and achieve real results for their organization and improve the quality of life of their employees.
