Manage high-risk and complex cases efficiently
You’re looking for ways to control medical costs of high-risk members and patients while preventing readmissions and improving outcomes.
Our solution, which is integrated into your workflow, allows you to assess and manage complex cases efficiently with a single, blended care plan, created from a patented assessment that merges condition components. Assessment questions cover medical, behavioral and social needs, in addition to comorbidities and cross-condition issues, allowing you to manage care holistically.

Efficiency and holistically manage high-risk and complex cases

Comprehensive assessments
The Primary Assessment addresses common care barriers, including SDOH. The care manager has the flexibility of adding one or more of 40 condition-focused modules to create a patient-specific blended assessment in real-time.

Personalized care plan
Merging assessment components for all relevant conditions enables the creation of a single prioritized care plan unique to the patient. Care plan outputs can be worked into your care management system workflow. Includes educational material for care managers and patients. Promotes self-management.

Easy integration
Integrate our cloud-based solution into homegrown or third-party care management delivery systems. Leverage the SaaS architecture to provide access across a networked system without increasing IT burden.

Supports compliance
Our solutions can help meet URAC (Case Management and Disease Management) as well as NCQA (HP-PHM5 and LTSS; MBHO-QI8 and LTSS; and SNP) program requirements.

Educational support
Reinforce education for specific conditions and condition management with companion member – and patient-acing fulfillment materials.
Key benefits
Efficiently and holistically manage the care of high-risk members and patients.
Use patented, blended assessments
General case management and disease-specific questions are blended into a single rules-driven primary assessment.
Leverage personalized care plans
Merging assessment components for all relevant conditions enables the creation of a single prioritized care plan unique to the patient.
Support care managers and patients
Improve patient education with materials to guide care managers through the consistent presentation of condition-related information.
Schedule a demo
Let us show you how to leverage our comprehensive, evidence-based clinical support solutions.

Related healthcare insights
On-demand webinar
Discover how to leverage automation for centralized, exception-based utilization management.
On-demand webinar
An Optum expert explains how hospital systems can transform their UM programs and drive efficiency with InterQual AutoReview.
Article
Discover how the InterQual team facilitated the timely adoption of new industry guidance for promoting health equity in clinical practice.