Care Management Impact Model


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Our care management impact model (CMIM) builds on our actuarial cost projections and allows the user to quantify the impact on resource utilisation from redirecting care within the system. We have worked with numerous local economies on re-modelling specific care management pathways and quantifying the impact of redirecting utilisation due to admissions reviews. While interventions are specific to each client, our tailored approach allows a range of different managed care programmes to be modelled, such as:

  • Admission avoidance programmes based on surgical interventions.
  • Length-of-stay programmes for medical and surgical admissions.
  • Referral management.
  • Encourage general practitioners (GPs) to only make referrals based on evidence based guidelines.
  • Primary care interventions.
  • Reduce speciality (consultant) visits by encouraging GPs to expand scope of practice.

Our unique expertise in developing actuarial cost projections and looking at anticipated costs at the service line level for a specific population and over a defined time period, combined with the CMIM tool allow a deeper analysis of the expected costs within the local system as utilisation is being re-allocated to other clinical categories. Given our long-term timeframe and population-level perspective, this also allows our modelling to incorporate changes in population structure.

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