ICW - Technology for Health

A new era begins for health insurance companies following the health fund 2009 initiation and introduction of morbidity referenced risk structure compensation (Morbi-RSA). Appropriate strategies and control tools must be implemented to be prepared for the future care business. As a result, comprehensive case management is becoming the central focus for health insurance companies.

The new care module of the ICW Care and Disease Manager solution will support efficient processing and managing of every care management element: starting with integrated or physician-centered care contracts, disease management programs (DMP) and prevention culminating in case-management, rate choices or bonus programs.

Individual contracts and cooperation such as contractual content, contractual partners, care providers, participating customers, regional availability, costs or reports are user-friendly. The documents and forms associated with the contract can be accessed at any time. The risk potential can be easily identified using existing billing data from the health insurance company's legacy systems. Relevant information can be imported in the care module to identify insured groups or individuals according to various criteria (e.g. risk, need for consultation or control). Intelligent acquisition and control processes will automatically alert the user when insured persons should be contacted.

Employees working in care management acquisition and control can save valuable time when using the ICW Care and Disease Manager care module, and dedicate this time to provide more personalized, targeted and integral consultations. This will increase the insured’s individual responsibility leading to improved compliance.

“Initially, we will implement the ICW Care and Disease Manager to operate our DMP programs. However, care management is increasingly gaining in importance in view of the newly introduced Morbi-RSA. This is the reason why we want to efficiently and successfully cope with the future care business by implementing the new care module,” explains Thomas Schaaf, BKK R+V’s division manager.