Managed Care Principles
CHC employs a “staff model HMO” system of care. We use the following managed care principles, all of which provide high-quality care at the best rates for our clients:
Onsite Staffing: Enhanced onsite staffing capabilities result in fewer inmates requiring offsite care. Investing in healthcare staff with excellent credentials allows CHC to provide more complex care on site. We provide telemedicine services, which brings specialty care inside the facility when specialists may not be readily available.
Pharmacy: CHC employs a Pharmacy Benefit Management approach to our pharmaceutical program, which includes implementing a preferred medication list (PML), working collaboratively with clients on our PML, educating our prescribers on cost-effective prescribing, and controlling distribution of pharmaceuticals. We use a number of tools in our approach, including electronic medication administration records, regular Pharmacy and Therapeutics Committee meetings, and in-house review by consulting and employed pharmacists experienced in managed care.
Offsite Care: CHC negotiates and contracts with hospitals and other community healthcare providers for offsite care. We use our own Utilization Management program to ensure appropriateness of care, by evaluating requests for treatment and providing concurrent review of hospital admissions and overseeing discharge planning. Although this approach is similar to other managed care organizations, CHC has the additional, important correctional healthcare experience and perspective that a managed healthcare organization may lack.