Unlocking the value of medical case management
GMMI’s Zaydee Capo, Vice President of Healthcare Services, tells ITIJ about a key component of their cost containment strategy
At GMMI, our dedication to pioneering innovative solutions in medical cost containment for international travellers in the United States is unwavering. With over 30 years of experience, we continuously refine our services to meet the unique needs of our clients and their members.
Central to our approach in containing costs while maintaining quality care is our Medical Case Management programme. This comprehensive initiative involves the continuous assessment, monitoring, planning, and coordination of patient care. Our goal is to ensure that individuals receive the necessary, most appropriate, and highest quality of care while optimising cost-effectiveness.
Our URAC-accredited Medical Case Management programme boasts a team of over 20 registered nurses and four doctors with extensive experience. These professionals play a vital role in directing members to suitable providers, facilitating post-discharge planning, and ensuring seamless transitions of care.
What truly distinguishes our Medical Case Management program is our steadfast commitment to evidence-based medicine. By leveraging clinical guidelines and the industry's most reputable criteria, our medical team ensures that healthcare-related decisions are grounded in the most current, proven, and reliable scientific evidence. This approach not only enhances patient outcomes but also contributes to cost containment by promoting the efficient use of resources.
Improving quality of life
Medical case management is about more than just coordinating care – it's about improving the quality of life for patients with chronic or complex conditions. Through guidance, education, and support, our case managers empower individuals to take control of their health and well-being, leading to better outcomes and reduced healthcare costs.
At GMMI, effective medical case management is a multifaceted endeavor. It involves delivering the right care, at the right time, with the right provider, for the right price, and the right outcome. By equipping our clients’ members with the tools and resources they need to make informed decisions about their healthcare, we aim not only to save costs but also to improve lives.
International insurers face unique challenges when their members require medical care in the United States, especially if they come from countries with universal or state-funded healthcare systems. The differences in healthcare systems and payment structures can lead to complexities and higher costs. That's why having a cost containment partner like GMMI becomes crucial. Our approach goes beyond building a network of providers and negotiating discounts. We believe in the power of medical case management to contain medical costs effectively. By leveraging our expertise and resources, we help international insurers navigate the complexities of the US healthcare system while ensuring their members receive the highest quality of care at the most cost-effective rates.
Our Medical Case Management programme is integral to our cost containment strategy, providing our clients with the assurance that their members receive high-quality care while minimising unnecessary expenses. As we continue to innovate and evolve, we remain steadfast in our commitment to delivering value-driven solutions that align with the dynamic needs of the healthcare landscape.
We believe in the power of medical case management to contain medical costs effectively
To summarise, medical case management serves as a crucial bridge between quality care and cost containment. By focusing on evidencebased practices and empowering patients, we not only save costs but also enhance the overall healthcare experience for individuals travelling to the United States. As the healthcare landscape evolves, we are dedicated to staying at the forefront of innovation, ensuring that our clients and their members receive the highest standard of care while maximising cost savings.