CareJourney® Codifies Leading Healthcare Delivery Models
Explore Eligibility, Implementation, and Compliance for all Types of Healthcare Delivery Models
01
Annual Wellness Visits (AWV):
Annual Wellness Visit to discuss care plan for the year
02
Chronic Care Management:
Comprehensive care plan for beneficiaries with two or more chronic conditions
03
Transitional Care Management:
Follow-up services for moderate- to high complexity inpatient discharges
04
Diabetes Prevention Program (DPP):
Clinical intervention model with the goal of preventing type 2 diabetes
05
End of Life Planning and Care:
Advance care directives; Home and palliative care
06
Collaborative Care Model (CoCM):
Integration of behavioral health care with primary care for beneficiaries with behavioral health conditions
07
Accountable Health Communities (AHC):
Provides enhanced clinical-community linkages with unmet health-related social needs
08
Million Hearts CVD Risk Reduction Model:
CVD risk calculation and population-level risk management for patients with hypertension
09
Shared Decision Making (SDM):
Communication with and education of beneficiaries with preference-sensitive conditions
10
Oncology Care Model (OCM):
Bundled payment for episodes of care surrounding chemotherapy administration to cancer patients
Featured Segmentation Model: Rising-Risk (Frailty)
CareJourney implements an open, peer-reviewed patient segmentation methodology published by the National Academy of Medicine that identifies the “frail elderly” as the largest proportion of high-cost patients. CareJourney tracks the frailty segment’s spend performance and produces actionable lists by provider.
