Preferred Health Management, available exclusively through the Lehigh Valley Physician Hospital Organization (parent organization of Valley Preferred), is a comprehensive health care management system proven to contain health plan costs while delivering the highest quality of care on a consistent basis. Preferred Health Management provides on-site health and wellness programs, disease management, case management and other health-related services.

Clinical Integration.
Built on the fundamental bond of trust between doctors and patients, Clinical Integration, through the Lehigh Valley Physician Hospital Organization, provides a measured progression of actions and support services to achieve better health potential. Clinical Integration provides stronger benchmarking of a patient’s state of health and the medical methods to optimize it. Potential problems are addressed while still treatable. Healthier lifestyles are promoted, measured and monitored. Doctors get support services enabling better patient care. Many serious health circumstances can be contained. And so can their costs.

Because we are comprised of those professionals most knowledgeable in medicine – doctors and hospitals – we are uniquely qualified to shape the processes which provide better health.

Uniquely structured to deliver real results.
While Preferred Health Management’s programs are patient-centric, respect is maintained for the patient-physician-care manager trinity. Comprehensive management through an integrated system of health plan rules, clinical protocols, caring professional guidance, financial management and feedback results in high standards of accountability, engagement and performance for patients, physicians and plan administrators.

Providing a more insightful approach to employee health management.
Preferred Health Management provides a structured team effort committed to achieving positive outcomes and rewards of improved health. Using nationally recognized clinical pathways and collaborative relationships between physicians, patients and employers, Preferred Health Management professionals engage in wellness through promotion of continuity of care, education and customized solutions supported by Preferred Health Management-designed systems and techniques to yield positive results on a consistent basis.

More than population health management.
Preferred Health Management does more than monitor the health of employee populations. Preferred Health Management assesses member health care needs and implements the best-practice disciplines required to improve individual health through partnerships with treating physicians.

Physician engagement.
Beginning with the view that practitioners want to do a good job, physicians self reflect to identify areas where there are knowledge-to-performance gaps with respect to chronic conditions. Disease specific audit tools were developed using evidence-based medical research to help practitioners track their own performance. The key standards of care are aggregated into a format where the doctor can develop an awareness of what they do well and what areas they can improve. It is in this process of self-discovery that the physicians become empowered to improve their own performance.

PHM spans the continuum of patient care from prevention through the ongoing maintenance of at-risk patients:

• Utilization Review: Preferred Health Management utilizes medical guidelines to determine the appropriateness of medical services, specifically monitoring inpatient levels of care, drug utilization, rehabilitation therapies, use of durable medical equipment and other services to provide high quality care in a cost-effective manner.

• Case Management: A nurse will develop a health care strategy that meets the specific needs of the individuals suffering from a catastrophic illness or injury while coordinating and monitoring all aspects of care to achieve the goals of an optimum health care outcome.

• Disease Management: Preferred Health Management takes the most costly chronic conditions and manages care through patient specific assessment, coaching and education to minimize complications, while promoting quality of life, avoiding exacerbation of disease and associated costs. More than 70% of the health care costs in our service area are consumed by individuals with diabetes, asthma, hypertension and heart disease. Preferred Health Management targets these and other conditions with programs clinically proven to reduce the effects of major chronic diseases.

• Wellness Programs: Employees are provided with a variety of educational offerings, including a Health Risk Assessment awareness tool to make the progression toward better health a way of life.

PHM produces REAL RESULTS

Excellent Diabetes Control
• 1.5% overall decrease in HbA1C
• 9% reduction in LDL cholesterol
• 32% increase in patients not at goal (130/80) treated for hypertension

Improved Diabetic Compliance
• 11% increase in daily food checks by patients
• 23% increase in annual eye examinations for patients

Less Asthma Symptoms
• 97% of patients have bronchodilator rescue medications prescribed
• 31% of patients have a decrease in severity of symptoms
• 47% of patients have an increase in knowledge of trigger removal
• 9% increase in patients receiving flu vaccination
• 33% increase in patients receiving pneumonia vaccination

Significant Lifestyle Changes
• 46% of members had decreased cholesterol
• 53% of patients have altered their diet to decrease salt intake
• 78% of patients have increased their exercise
• 53% of patients worked at losing weight

Reduced Medical Cost
• 72% decrease in admissions
• 77% decrease in hospital days
• 42% decrease in ER visits

Less Work Absences
• 48% decrease in the number of absences
• 57% decrease in number of days absent

If you are an employer interested in containing health care costs and promoting better employee health and productivity through the programs of Preferred Health Management, please contact Valley Preferred or call 610-969-0480 or 1-800-955-6620.