Transcend’s approach to value-based care emphasizes efficiency and effectiveness. Locally based teams working onsite in your practice deliver tools and services that enhance care coordination and support improved outcomes. Our care coordination activities include:
New Member Assessments
Ongoing outreach and assessment of new members for clinical program eligibility under their plan benefits.
Evaluation of utilization patterns and clinical outcomes for enhanced predictive modeling for potential prospective care management.
Physician decision support
Real-time health insights about gaps in care and clinical inference generated from the clinical rules library (based on industry guidelines) to promote the highest quality of care
Condition management coordination
Liaise between PCPs and appropriate chronic care programs or alternative services to minimize the impact of illness burden or conditions
Prescription consulting services to identify drug-to-drug interactions and medication non-adherence
Member, provider and system reporting on all aspects of the care coordination experience so you can identify opportunities for improvement
Management of Key Clinical Events
Transcend works with you to establish evidence-based best practices and facilitate frequent physician-to-physician collaboration opportunities. Our committee and meeting structures support sharing of successful strategies, including how to manage appropriate utilization while providing care and improving health.
We help ensure your success through care navigation nurses who offer support according to the needs and goals of your patients. Our care navigators work to identify resources and programs appropriate for each patient’s care plan, providing additional touch points and helping your practice with its ongoing efforts to involve your patients in their own care and improve the quality of care.
Our teams work with you and your staff as patient advocates to facilitate communication between care teams and patients to maximize patient health outcomes. Our care navigators offer post-discharge support, assistance with medication management and other care coordination activities.