Allied Benefit Systems

Allied's Enhanced Case Management Program recently identified a member who was receiving specialty infusion treatments every four weeks at an outpatient hospital setting costing nearly $21,000 per infusion. Allied’s ECM team explored opportunities to lower costs without disrupting treatments. Through careful research and coordination with the member and their provider, ECM helped transition the member's care to their home, where they could safely continue receiving their treatments. During a routine follow up outreach, the member expressed to their ECM Advocate that they appreciate the comfort and convenience of receiving their treatments at home. Through transitioning the member’s site of care, infusion costs were reduced 32% each treatment, saving the employer over $80,000 in a single year.

To find out more how Allied’s ECM can positively impact healthcare costs, go to alliedbenefit.com.

In 2020, mental health-related emergency department visits among those aged 12 to 17 increased 31% compared to 2019, according to the CDC. As many families prepare to return to in-person school in the fall after more than a year of stress, isolation, grief and fear, how we address the mental health needs of students will be critical. Between stigma and limited resources made available to young adults, Allied’s Enhanced Case Management aims to reimagine how we help our members by taking a holistic and empathetic approach to health and wellbeing. By using data analytics and personal outreach, Allied’s ECM Specialists engage our members in a more proactive and connected way.

In a recent case, a dependent child was admitted to the hospital after engaging in self-harm. Allied’s ECM Specialist reached out to their family, understanding that the child had an ongoing battle with mental health and was struggling to cope. After building a rapport, the ECM Specialist worked with the member and their family to build a long-term plan, connecting them with an appropriate mental health provider. With the ongoing support and resources from ECM, the member has been able to stay on track with their course of care.

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Employers and Health Plan Administrators together have an incredible opportunity to drive workforce wellness by ensuring members have access to high-quality and appropriate care. While many look to our physicians and pharmacies as the point of safeguard, a significant influencer is the role of payers - like Allied.

Allied’s Enhanced Case Management (ECM) team uses data analytics and clinical expertise to make sure our members are protected and empowered when it comes to their health care.

In a recent case, the ECM team identified a new member prescribed a Medication-Assisted Treatment (MAT) for opioid use disorder who was filling two separate prescriptions for this same treatment drug. Through evaluation, the ECM team also learned that this member had multiple ER visits related to stress and anxiety. Soon after the employer switched to Allied, the ECM team reached out to the member – to offer support, educate about safe prescription use, and advocate for the member to have more regular visits with their addiction counselor. In recent follow-ups with the ECM specialist, the member shared their progress in coping with anxiety and confirmed that their prescriber had reduced their prescription quantity by half.

Allied is pleased to announce that Merlinos & Associates, Inc. has released an actuarial analysis documenting the performance of Allied Advocate — Allied’s nationally recognized claim and cost mitigation program. Designed to ensure members have access the care they need, Allied Advocate protects members against balance bill exposure and secures appropriate reimbursement rates.

Launched in 2005, and embedded in thousands of employers’ plans, Allied Advocate is one of the most successful claim cost mitigation platforms in the United States.

"Allied Advocate has a long track record of successfully helping employers control their health plan's claim costs. This important study will be used by brokers, consultants, stop loss partners, and their actuaries across the country as a tool to assess how Allied's products and services can reduce their client's health care spending.” - Rob Valerious, Allied's Executive Vice President

To learn more, please contact: Michelle Meiri - Marketing Manager, ([email protected]), or your Allied Account Executive.