Total Population Health Management

Seeking to improve outcomes, promote well-being and significantly reduce medical expenses.

Effective health risk management strategies led by experienced clinical and analytical staff integrating clinical data and risk management to produce a successful, holistic healthcare benefit plan. Our health improvement strategies relieve worry from your employees and workload from your HR staff.

  • Predictive Modeling
  • Risk Stratification
  • Benchmarking Programs
  • Targeted Clinical Management Interventions
  • Health Coaching
  • Quality Care Standards

ARS Utilization Management (UM)

Utilization Management includes preadmission hospitalization review, concurrent review, discharge planning and pre-service medical necessity determinations for procedure review/service review, and high cost specialty drug review. CBS nurses work closely with the providers and members to assure plan services are medically necessary and in the appropriate setting.

ARS Case Management (CM)

Case Management includes early identification and intervention for high risk members, potential large claims, ongoing care conditions, and catastrophic diagnoses.
Our program assigns a RN Certified Case Manager (CCM) to each potential CM candidate to assess the individual’s needs and develop a personalized medically appropriate care plan in cooperation with the member’s physician. The RN Case Manager then supports and guides the member through the treatment and recovery process. The result is cost-effective quality care.

CBS provides a Total Population Health approach to improve member health and well-being. The YFH team of wellness and clinical professionals are dedicated to support the needs of all plan members CBS consults with our client to create a tailored relevant wellness program for your plan membership. The capabilities of the program include:

  • Single Sign-on & Secure Online Access
  • Tools for Optimal Health Outcomes
  • Member Enrollment Surveys
  • Aggregate Health Risks Report Generation
  • Raffles for Participation
  • Lifestyle Activity Participation
  • Library of Health Resources
  • Participation Incentives Tracking Reports

YFH Wellness Initiative (WI) is open to all plan members. Program enrollment into the Wellness Initiative is easily accomplished on the Member Dashboard or by phone call to the YFH Program. The YFH Coaches encourage members to complete the health assessment and obtain routine preventive care exams to identify health risks to educate members on goal setting and health improvement through:

  • Interactive Health Assessment
  • Classes and Courses
  • Onsite Lunch and Learns
  • Health Trackers
  • Incentive Tracking and Reporting
  • Messaging to the Clinical Staff
  • Goal Setting
  • Community Resources
  • Incentive Raffle Rewards

YFH Condition Management Achievement Program (CMAP) is available to Members with targeted chronic conditions. Members are invited to participate and can enroll by phone call or via the Member Dashboard.

  • Diabetes
  • Hypertension
  • Hyperlipidemia
  • Chronic Renal Disease
  • Chronic Pain
  • Asthma
  • COPD
  • Cardiac Disease

A YFH nurse coach assists members using motivational support and tools available on the Member Dashboard to establish personal goals, keep focused and in alignment with physician recommendations for a lifetime management of chronic conditions.

Get started on managing Your Future Health today!

CBS Clinical staff understands the patient care needs and opportunities for intervention that are associated with risk identified through organized health data. Our metrics utilize HEDIS measures, national guidelines, and evidence-based medicine practice protocols. We align members with the CBS Health Management Program – UM, CM, Wellness, Condition Management – to meet patient needs, fill gaps in care and minimize future risks using the following data sources:

  • Medical Claims
  • Rx Claims
  • Lab Results
  • Health Assessments
  • Biometrics
  • Member Dashboard Information
  • Data from Third Parties

Unmatched risk prediction and health management capabilities are optimizing member health and containing client costs. Our clients receive actionable analytical reporting with recommendations for member engagement, health improvement and strategies for better utilization of medical providers with the following:

  • Financial Analytics
  • Benchmark Reporting
  • Risk Analytics
  • Predictive Modeling
  • Quality of Care Metrics

The information roadmap for a successful health plan.