Whole Person Approach to Clinical Services
Sagility harnesses technology-enabled healthcare management solutions to enhance comprehensive individual care and interventions, thereby elevating health outcomes, diminishing expenses, and amplifying satisfaction. Our dedicated teams, both onshore and offshore, comprise more than 1,500 nurses, pharmacists, occupational therapists, physical therapists, social workers and health coaches supported by family practice and specialist MDs.
- 35-40% reduction in cost of clinical operations
- 40-50% improvement in productivity through Machine Learning tools
- Improved member engagement through whole person care approach
Contact us now to explore our full suite of services, including Utilization Management, Aging in Place, Care Management, Appeals, Telehealth, and other clinical reviews for Payers, Providers and Ancillary Healthcare Providers.
Sagility’s URAC accredited program offers an end-to-end process for managing Payer Utilization Management (UM) policies or generally accepted Appropriate Use Criteria (AUC) using automation technology, delivering real time clinical decisions on prior authorization to providers during the intake process.
Utilization Management as a Service (UMaaS): Our UM solutions are highly flexible and configurable to client’s requirements. We offer a single, unified UM solution (Intake, High-impact Clinical review, MD reviews, and Appeals reviews) that delivers financial cost savings from efficient processes, faster turnaround times and reduced provider burden:
- – Hybrid staffing solution
- – An educative peer review process
- – Pre and Post-service reviews
- – Web-based, real-time clinical decisioning engine
- – AI/ML-led Nurse Assist tool
- – Clinical analytics and deep business insights
- – Care management integration
Specialty Solutions: Sagility UM Specialty Solutions are clinically advanced, deep domain driven offerings to manage a specialty end to end. Our specialty solutions use highly optimized, academic guidelines integrated with specialty peer review, along with combination of medical necessity and educative processes to ensure clinical appropriateness. We deliver high impact in several clinical specialties, including:
- – Cardiology
- – Endoscopy
- – Genetic Testing
- – Musculoskeletal
- – Spine & Pain Management
- – Sleep
- – Surgery
- – Varicose Veins
Aging in Place
An innovative and clinically evidenced technology led solution to help elders live a functionally independent life at home and to reduce total cost of care and improve STAR rating for MA plans. Our solutions include Frailty risk identification and Prevention, and Fall Risk identification and Prevention.
Falls Prevention: Falls Prevention is a proven solution to counter falls risk in older adults, which drives elevated care costs and influences 90% of MA plans’ STAR ratings.
- Our program predicts fall risk and proactively combats it via a comprehensive assessment. A dedicated care manager aids members in mitigating fall risks, imparting supportive education for enhanced survey responses and improved HEDIS outcomes. Leveraging omni-channel communication for optimal engagement, our approach adopts a whole-person care model backed by adaptable rule-based workflows and care plans, effectively reducing and averting fall risks.
Frailty Management Solutions:
- – Predictive Frailty analytics
- – Whole Person Care clinical interventions
- – Medicare Supplementary benefit navigation
- – Digital and Care manager interactions to help build resilience
Care and Case Management
The care management program is an evidence-based solution for Medicare, Medicaid, and Commercial Payers and Providers to address multi morbidities and common disease prevention. Positive outcomes include cost of operations reduction, cost of care reduction, compliance to quality of care initiatives, and an improvement in STAR rating.
Proprietary Predictive Analytics
- We identify members with the most impactable health deficits.
Global Clinical Service Delivery
- Multi disciplinary care teams, combined with omni-channel communication efforts are used to maximize engagement.
Whole Person Care Interventions
- Once engaged, a whole-person care approach supported by proprietary configurable algorithms and clinical assessments and interventions help members and their healthcare providers to stabilize the member’s health status, remove common barriers, build self-efficacy, improve adherence to prescribed care, and promote healthy behavior changes.