The Right Care at the Right Time
With healthcare costs on the rise, maintaining the health and wellbeing of member populations more important than ever. Our Clinical Health Solutions program helps to individually assess and address each members health concerns, allowing clients foster a healthier member population overall.
Healthcare Management
Our in-house, fully-integrated healthcare management team is there to help advocate for, guide, and support members when they need it most, all while delivering substantial savings for our clients.
Our team of intake coordinators, support staff, utilization review nurses, and case managers work together to effectively help manage each patient’s care, prevent unnecessary services, and facilitate communication among providers. When a patient’s care is in question, issues are reviewed and, if necessary, the course of treatment may be transitioned by their provider to an alternative method of care.
Case Management
Our member-centered case management program delivers compassionate support and clinical expertise to members with complex health issues to help improve patient outcomes.
Trust our team of clinical experts to provide:
• Focused Case Management Programs
• Experienced Case Managers
• Population-Specific Resources
• Integration with Specialty Services
• Member Education, Advocacy, Care Coordination and Treatment Plans
• And more
Quality Care with Utilization Management
Utilization management enhances the quality of care by evaluating medical necessity, appropriateness, and efficiency of healthcare services, procedures, and facilities under the provisions of a client’s health benefit plan.
Our utilization management program provides a top to-bottom suite of services including pre-service review, concurrent review, retrospective review and appeals.
Base-level Utilization Management Includes all inpatient admission pre-certification for:
Our utilization management program provides a top to-bottom suite of services including pre-service review, concurrent review, retrospective review and appeals.
Base-level Utilization Management Includes all inpatient admission pre-certification for:
- Acute and Long-term Acute Care
- Skilled Nursing Facilities Residential
- Treatment Centers
Best-in-class Vended Solutions
To help match members with the right care, we’ve developed a suite of best-in-class vended solutions that provide personalized support for an array of health conditions and concerns.
A Good Fit for Clients Seeking:
Flexibility
Design control
Variety of vendor options and integrations
Ability to bring or substitute their own vendors or solutions
Quick implementation
Connect with a Luminare Health sales executive to learn more.
1Not all data points may be available for all clients.
2 Oliver Wyman, 2014. Adjusted to compress health status categories. Acute episodic care costs excluded from analysis.
3 Savings based on diabetes anchor condition using multi-condition ROI methodology, white paper available upon request, Teladoc Health, 2022.
4 Add a spouse/domestic partner to a primary membership for additional monthly fees. Spouses/domestic partners must be 18 years or older. Fees may vary based on fitness center selection.
Vended solutions are independent companies that have contracted with Luminare Health Benefits, Inc. to provide programs for members of self-funded medical benefit plans administered by Luminare Health Benefits, Inc. (Luminare Health). Luminare Health make no endorsements, representations or warranties regarding third-party vendors and their products and services offered by them.
2 Oliver Wyman, 2014. Adjusted to compress health status categories. Acute episodic care costs excluded from analysis.
3 Savings based on diabetes anchor condition using multi-condition ROI methodology, white paper available upon request, Teladoc Health, 2022.
4 Add a spouse/domestic partner to a primary membership for additional monthly fees. Spouses/domestic partners must be 18 years or older. Fees may vary based on fitness center selection.
Vended solutions are independent companies that have contracted with Luminare Health Benefits, Inc. to provide programs for members of self-funded medical benefit plans administered by Luminare Health Benefits, Inc. (Luminare Health). Luminare Health make no endorsements, representations or warranties regarding third-party vendors and their products and services offered by them.