Health Integrated is leading the reform of our health care ecosystem by changing the behavior of its participants to protect our most vulnerable members.
Understanding and addressing the relationship of behavioral, social and medical needs of the individuals we serve permeates our DNA. Working with Medicare, Medicaid, Dual-Eligible and Commercial plan members nationwide, we bring to bear innovative care management strategies enabled by differentiated technologies to drive better health outcomes, higher member satisfaction and lower health care costs.
Executive Leadership Webinars
Medicare Advantage RAF Strategies
Wednesday, November 20, 2013, 2:00-3:00 PM ET
Innovative Care Management Strategies
Wednesday, October 23, 2013, 2:00-3:00 PM ET
Delivering Mandate Models of Care
Wednesday, September 18, 2013, 2:00-3:00 PM ET
Outcomes Reporting is All About Perspective
Wednesday, July 31, 2013, 2:00-3:00 PM ET
An Intellectual and Cultural Affair to Remember
Posted on: Thursday, September 19, 2013
Of People, Places and Culture ... a Personal Journey Continued at the World Economic Forum
Posted on: Wednesday, September 18, 2013
She’s one of 9 million people in the U.S. covered by both Medicaid and Medicare. With multiple chronic conditions, as well as clinical depression, Julia has many challenges. Plus plenty of responsibilities. As a single grandmother, she is raising two of her grandchildren. She’s actively involved in their lives, but her diverse health needs slow her down. Living on a fixed income and with no car, getting to doctors’ appointments isn’t always convenient for Julia, or even her first priority. Yet, with reminders and help from a care coordinator, Julia’s health—and her independent outlook—are improving. Learn how we can help your dual eligibles.
*Kaiser Family Foundation
Half of those suffer from more than one chronic condition, putting them among our nation’s most vulnerable population. And when you consider the cost of their care, as much as 83% of your plan dollars may go to treating these members. We can help you change those numbers—and the personal stories they hold—for the better. Health Integrated provides holistic attention for your frail, sick and elderly. And we forge strong connections with their providers, too. Our approach to communication and coordination throughout the health care ecosystem is highly efficient, high‐tech, yet very human. The results: Healthier members. Lower plan costs.
*Partnership for Solutions National Program Office, Robert Wood Johnson Foundation
Born with cerebral palsy, Justin’s life hasn’t been easy. And his monthly medical bills are frequently in the thousands. Justin comes from a working family. Now in his early 20s, Justin recently transitioned from his parents’ house to an independent living center and his life skills are improving. It was a big change. And it took more than a supportive family. Our outreach coordinators helped Justin, his family, his doctors, his providers and his new caregivers prepare for his new life, making things easier for everyone.
*Kaiser Family Foundation
She’s one of about 8,000 people who turn 65 every day in the U.S. Retired and living a continent away from her children, Ruth’s age is beginning to show. She’s a bit frail and could really use help figuring out what health care services are available to her through Medicare. Fortunately, a little care coordination can go a long way for your Medicare Advantage members. We help you retain those members, without adding unnecessary costs.
They are among the 65% of people from working families who receive Medicaid to get much needed health coverage for themselves and their families. Their first child, Kayla, is one of the 3%** of children in the U.S. with a disabling birth defect. When Kayla arrived, her parents needed help navigating the health care system and communicating with doctors and hospitals to get the right services for their daughter… and help with caregiver support. No one should have to face something like this all alone. Yet the extra attention doesn’t have to cost a lot extra.
*Kaiser Family Foundation
**Center for Disease Control
He’s among the estimated 300,000 Gulf War veterans alone who will suffer from post traumatic stress disorder and struggle to return to some semblance of a normal post‐military life. Working with a Care Coach who also happens to have walked a mile in a veteran’s boots, Paul gets the support, guidance and encouragement that helps him once again enjoy the freedoms he gave up so much to protect. We also help make sure his local VA hospital is up-to‐date on Paul’s condition to provide well‐deserved, deep‐level assistance. Even the strongest members of our society need a shoulder to lean on now and then. Make those shoulders yours. We can help.
*Michele Rosenthal, Before the World Intruded
A recovering drug user, Serena is one of more than a million people living with the disease. And one in five of those don’t even know it yet. Of course, today’s treatments make it possible to live a long and productive life with the HIV virus. But education, care planning and coaching are important determining factors. Find out how we help members like Serena follow their care and prescription drug plans to stay out of the hospital and live the healthiest lives possible. It’s a win‐win… better quality of life for your members, better outcomes for your health plan.
*Center for Disease Control
It's a fact that plays out across the United States year after year in over-testing, treatments that aren't medically necessary or just plain old over-treatment. Need proof? A 2005 Academy of Sciences report found that 30% of U.S. health care spending was unnecessary or wasteful. More recent studies arrive at similar figures. That amounts to a staggering $600 billion to $700 billion annually. We take a better approach...the right care in the right setting from the right provider and the right time. We'll show you the results.
*Academy of Sciences
Changing Behavior in Health Care
What happens when you enable, empower, and encourage your most vulnerable health plan members to better care for their own health? And when you help them navigate the complexities of our health care ecosystem? Truly remarkable change. Fewer missed appointments. Reduced emergency visits and inpatient admissions. Better adherence to care and prescription regimens. Improved quality of life. Stronger member-provider connections. And, lower lifetime costs. That’s Health Integrated. In everything we do, we approach medical, behavioral and social health as an integrated whole to get at deeply held barriers and beliefs that get in the way. It’s how we change behavior in healthcare. For the better.
The vulnerable members of your population have complicated, costly, often overwhelming chronic health conditions. Add a serious behavioral health condition to the mix and the cost of their care sky rockets, along with their risk for episodes of acute care needs. Our care management approach brings together medical, behavioral and social health management strategies in a holistic, integrated environment that ensures doctors, hospitals and other providers consider your health plan member as an individual, not just a chart. Our experienced teams deliver comforting, high-touch member experiences. We interface with hospitals, skilled nursing and other facilities to ensure care plans are realized and all parties are synchronized as a member moves through the health care ecosystem. The caring, ongoing dialogue we build inspires trust and genuine commitment, helping your members get healthier, proactively and cost-effectively.
Chronic Condition Management
When it comes to addressing the needs of members with multiple chronic conditions and related co-morbidities, Health Integrated provides unparalleled vision into the medical, behavioral and social health complexities of this population to better improve their health.
Synergy Targeted Population Management®, Health Integrated’s flagship product, succeeds where traditional disease management programs fail by addressing the actionable root causes driving higher health risks, negative health outcomes and unsustainable high health expenses. Our proprietary identification algorithms enable us to target individuals with diagnosed and undiagnosed behavioral factors. Our interventions go beyond information therapy to deliver truly integrated and enabled care in partnership with members’ providers and community supports. Our sophisticated informatics provide compelling evidence for why Synergy continues to deliver attractive and plausible returns for plans.
Health Integrated’s Medical and Behavioral Case Management help vulnerable individuals through some of the most challenging times of their lives – when they are in the midst of an acute health crisis or are struggling with complicated advanced conditions. Case Managers advocate for members and synchronize their providers to ensure that treatment plans are established and executed to achieve optimal outcomes in the most cost-effective and member-beneficial way. Case Management is URAC Accredited.
Models of Care
Special Needs Plans. Aged, Blind and Disabled. Long-Term Care. Our Models of Care address the care management needs and compliance requirements of managing these vulnerable populations. Delivered by highly experienced clinicians through a comforting, high-touch member experience, this product is quintessentially Health Integrated – focused on the frail and fragile, tightly integrated in addressing medical, behavioral and social needs, delivered through highly personalized interventions and deeply devoted to coordinating care across the health care ecosystem.
Supported by today’s best technology to track and communicate progress to all care participants, this turnkey solution can be tailored to a plan’s unique objectives. It includes all critical elements required by CMS: Health Risk Assessment, Individualized Plans of Care, Interdisciplinary Care Team, Stratification, Care Management Interventions, Transitions Management and Outcomes Measurement.
Transitions in Care
There is no greater challenge for a vulnerable member than transitioning from an acute inpatient stay. And there is no greater driver of avoidable expenses for a health plan than a poorly managed transition in care that leads to a readmission. Health Integrated works with members from admission through discharge planning and post discharge services to bring the greatest level of independence, autonomy and care outcomes to members when they are most needed. Our programs include care coordination, care facilitation and even highly efficient home-based monitoring for interventions that keep members where they want to be and where they can receive the best care – in their home.
Member Support Lines
In times of crisis, Health Integrated is there. Our Behavioral Health Crisis Lines and Nurse Advice Lines are available 24/7 to help members in times of need. BH Crisis Line is staffed by licensed behavioral health clinicians who compassionately and effectively help members and their families address the unique safety issues associated with urgent or emergent behavioral health crises.
Managing Care, Settings, Clinicians and Cost
Clearly, the landscape is changing for health plans. You're feeling pressure to contain care costs like never before. Sometimes the simplest way to stay on top of those costs is by digging deeper to discover the root causes of and behavioral drivers that can combine to worsen issues. That's our Utilization Management program. We take a closer look behind the scenes, and ask some basic questions. Is this really the right level of care for the situation? Are we delivering it in the most appropriate, comfortable and cost-effective setting? Is the right clinician assigned? Are our reimbursement levels accurate? Seeking to proactively answer these questions with each of your most vulnerable members, then working with their providers and clinicians, we help you serve individuals better, and your entire membership more cost-effectively.
Medical and Behavioral Utilization Management
Our philosophy is that the best outcomes for patients are derived from appropriate treatment in the least restrictive level of care available. Medical and Behavioral Utilization Management ensures that members receive medically appropriate care at the right care level, setting and time frame and are protected from the risks of unnecessary and often costlier care. Utilization Management is NCQA certified and URAC accredited.
Physician Review Services
Physician Review Services support the Utilization Management process by providing board-certified medical and psychiatric physician reviewers to assist in making determinations of clinically appropriate use of medical and behavioral health care services. Health Integrated’s goal is not to deny services, but to ensure that care is occurring in the right time and the right setting in order for members to obtain optimal outcomes.
Health Integrated psychiatrists review cases and provide expert behavioral health information and advice to enable attending clinical teams to reach proper decisions around diagnoses, medical necessity and course of treatment at admission and on an ongoing basis for patients with psychiatric co-morbidities. Health Integrated physicians advise on the manageability of patients and appropriate level of care, and assist in shaping treatment plans based on patients’ changing needs.
Even in an environment with effective authorization support, providers make post authorization care delivery decisions that can lead to waste. Health Integrated’s Payment Integrity reviews what was actually done against what was authorized, what was medically necessary and what state and federal funders have mandated. Using CMS data and provider expertise, Health Integrated performs comprehensive chart reviews to identify where the plan can recapture lost value, gain control of utilization practices and push provider relations to an equitable set of outcomes. For the plan, net ROI runs between 6:1 and 12:1 using a two-year look back window.
Delivering Relevant, Actionable Information
Analytics • Stratification
Amid the industry turmoil, there is significant opportunity. But you can’t gain an edge without a clear view…and you can’t manage what you don’t measure. We apply our informatics expertise to help you understand your populations better. We identify members most in need and likely to benefit from our patient-centric services. We stratify members to target interventions, appropriate to their needs. With greater member insight, you can deploy your dollars most effectively and know the results of every dollar you spend. Together, we create a consistent, 360-degree view into program opportunities and performance by continually revealing areas for greatest impact. Knowledge is indeed power. We'll help you get the facts so you can make smart decisions that ensure results and benefit your members...and your bottom line.
Portals • Care Management Platform
Your members want to take care of themselves better. But the complexity of today’s health system can be overwhelming, especially when combined with sudden or ongoing pain, distraction, inconvenience and even fear about their specific condition. A knowledgeable guide can help coordinate complex care strategies across a bewildering array of drug and physical therapies, dietary restrictions, primary and specialty care visits, hospitals and other facilities and, often, conflicting treatment plans. We use the best of today’s technology to monitor, track and communicate member progress to all care participants throughout the health care ecosystem. It’s how we influence member engagement, connect with community resources and collaborate with providers to close care gaps for your members. Imagine the comfort this brings to a careworn member and the peace of mind it provides to your health plan.
According to the CDC, more than 133 million people are part of vulnerable populations in the United States by virtue of their health status alone. And that number grows larger by the day. As a leader at your health care organization, you know that each member ID represents a real person who may need significant care at some point in the future. The path their health takes is influenced by the services you provide today.
Health Integrated is changing the health care ecosystem by promoting behavioral, mental and social change among the diverse range of participants. One way is by sharing the latest thinking, statistics and evidence based results from around the world and by inviting you to engage with us to improve the care of those most in need. Through exceptional live events, timely webinars and published white papers, we bring you the knowledge you need to create the change we all want to see in health care.
*According to the CDC
There has never been a more critical time for health plans to incorporate patient‐focused care coordination solutions that will lower costs, improve efficiency and enhance quality of care. Each year, we offer the forum for industry thought leaders to come together and share perspectives, ideas and results in a stimulating, educating and collaborative environment.
Health Integrated’s Executive Leadership Series (ELS) 2014 Summit will provide leading health plan executives from top health care organizations with the platform needed to discuss key business challenges and strategies.
Save the Date!
Health Integrated ELS 2014 Summit
Transformation & Innovation in Health Care
March 25-26, 2014 • Don Cesar Beach Resort, St. Pete Beach, Florida
Past ELS Summits:Executive Leadership Series 2013 Summit
Executive Leadership Series 2011 Summit
March, 2011 • Clearwater Beach, FL
Executive Leadership Series 2010 Fall Summit
September, 2010 • Chicago, IL
Executive Leadership Series 2010 Spring Summit
April, 2010 • St. Petersburg, FL
Building an Effective Model of Care for Members and Regulators
Thomas M. Ball, MD, MPG, Chief Medical Officer, University of Arizona Health Plans
Gaining valuable insight into the latest thinking on helping your most vulnerable populations take control of their health for improved quality of life is just a mouse click away … right from your desktop. Check out these information-packed, complimentary webinars, for you and your colleagues.
Past 2013 Webinars
Medicare Advantage RAF Strategies
Wednesday, November 20, 2013, 2:00-3:00 PM ET
Quality Measurement - How Do You Measure Up?
Wednesday, June 26, 2013, 2:00-3:00 PM ET
Overuse of Emergency Rooms
Wednesday, May 22, 2013, 2:00-3:00 PM ET
Care for the High Risk Chronically Ill
Wednesday, April 24, 2013, 2:00-3:00 PM ET
Reducing Avoidable Hospital Admissions
Wednesday, February 27, 2013, 2:00-3:00 PM ET
An Ounce of Prevention
Wednesday, January 30, 2013, 2:00-3:00 PM ET
Past 2012 Webinars
Advanced Strategy for Behavioral Health Care Management
Tuesday, December 11, 2012 2:00-3:00 PM ET
Trends in Integrated Case Management
Tuesday, November 27, 2012 2:00-3:00 PM ET
Health Literacy Meet Your Members Where They Are
Tuesday, October 30, 2012 2:00-3:00 PM ET
A Day In the Life of an Outreach Coordinator
Tuesday, September 25, 2012 2:00-3:00 PM ET
Impact of PCP Shortage on Access to Care
Tuesday, August 28, 2012 2:00-3:00 PM ET
Patient Centered Care for the Future
Tuesday, July 24, 2012 2:00-3:00 PM ET
Supreme Court Ruling on Healthcare Reform
Friday, June 29, 2012 2:00-3:00 PM ET
SNP Series Part 2 - SNP NCQA Structure and Process
Tuesday, May 22, 2012 2:00-3:00 PM ET
SNP Series Part 1 - SNP MOC Best Practices
Tuesday, April 24, 2012 2:00-3:00 PM ET
Download and share detailed explorations and research results to help you and the rest of your executive team make the best possible decisions for your most vulnerable population.
Case Management Society of America
Care Coaching: An Alternative Approach to Managing Comorbid Depression
Read how our whole-person approach has created positive change for individual members … and measurable results for major health care organizations. Download one or more case studies today.
Health Plus New York
At Health Integrated, our team truly becomes an extension of yours. For every one of your members that we work with, we can draw upon a multidisciplinary team of experts in behavioral and medical health. We built our company with a diverse complement of expertise in medicine, technology, marketing and business management to help you achieve your mission. Meet some of the team...
Shan provides the overall strategic leadership and visionary direction for Health Integrated and has a consistent track record of vision, leadership and success in the health care industry. Before joining Health Integrated, Shan cofounded and directed a number of companies in the medical technology area, one of which approached $70 million in annual sales and had market capitalization of approximately $450 million. Shan currently sits on a number of private company boards and is a graduate of Harvard University.
Sam Toney, M.D., Executive Vice President, Clinical Integrity & Chief Medical Officer
Sam provides primary clinical, program and criteria oversight for Health Integrated and brings more than 20 years of expertise in designing and implementing successful specialized behavioral health disease and case management programs across the country. A board-certified psychiatrist, Sam founded Health Integrated in 1996 in response to the growing need for sophisticated care management systems that address both the medical and behavioral health issues affecting patient care. Sam is licensed to practice medicine in 25 states and is also board certified in utilization review and quality assurance.
Thomas M. Bendoraitis, Executive Vice President, Finance & Chief Financial Officer
Tom has more than 20 years’ experience in the health insurance industry. In addition to providing financial management, Tom has also managed the delivery of customer services, account and network management services, and systems management and development. Prior to joining Health Integrated, Tom served as executive vice president and Chief Financial Officer of Magellan Behavioral Health, where he had responsibility for the financial operation of Magellan's managed behavioral health businesses. He also served as Chief Financial Officer and Chief Operating Officer at Humana Affairs International, Inc., a former subsidiary of Aetna, Inc.
Tracy Korman, Executive Vice President, Marketing Strategy and Customer Solutions
Tracy is responsible for corporate and product strategy, pricing strategy and developing Health Integrated’s product and marketing assets. Prior to joining Health Integrated, Tracy was founder and Chief Executive Officer of Longitude Health, an employer-focused health and wellness improvement company. Before that, he was the Executive Vice President of Strategic Marketing and Business Development for Ovid Technologies, a $350+ million/year business unit of Wolters Kluwer Health. At Ovid, he led the development and launch of the next-generation Ovid platform, a leading medical information resource for hospitals, practitioners and researchers. From 1996 through its sale in 2004, Tracy was co-founder and Executive Vice President of Marketing, Sales and Customer Relationship Management for Broadview Networks, the leading data and telecom alternative to Verizon in the Northeast. Tracy started his career as a consultant with Booz, Allen & Hamilton. He is also a returned Peace Corp volunteer and a graduate of Harvard Business School.
Zachary Fritz, Executive Vice President, Sales & Client Services
With a distinguished background in sales and client service management, Zac focuses on strategies that deepen the company’s role as a trusted adviser to Medicare, Medicaid and commercial health plans and provide comprehensive compliance, care management and revenue optimization services to Co-Ops and plans participating in the Exchanges.Previously, Zac was vice president and general manager for Truven Health Analytics, Ann Arbor, Mich., a healthcare data and analytics company and senior vice president, sales and marketing, at MyHealthDIRECT, Brookfield, Wis., a company that offered services to Medicaid and dual-eligible managed care organizations, health systems and care management companies.
Brad Weaver, Executive Vice President, Customer Delivery & Chief Delivery Officer
Brad joins Health Integrated with more than 20 years’ health care industry experience. He previously led the Service Delivery & BPO Group at Evolent Health, where he helped build their population management and service delivery capabilities. Previously, he has held senior leadership roles in quality and risk management, service delivery and business process outsourcing teams. Brad helped develop United Health Group’s ACO model organization, OptumHealth Collaborative Care, and designed, built and implemented care management programs and medical cost management strategies and tactics for Medicare and commercial populations. He has also worked in the government programs space helping Medicaid and Medicare managed care companies operate more efficiently, comply with federal and state regulations and meet or exceed performance requirements. Brad holds a degree from Dartmouth College and is a six sigma black belt with deep expertise in business process re-engineering.
Sharon Shirley, Senior Vice President, Corporate Resources
With more than 25 years of experience in managed health care, Sharon joined Health Integrated in 2008 and is responsible for Human Resources and Training and Development. She worked for Prudential Healthcare and its pharmacy benefit management partner, Integrated Pharmacy Solutions (IPS), for 16 years, holding various operational and administrative positions, including Executive Vice President at IPS, where she developed operational and corporate infrastructure, including human resources and organizational development functions. Sharon holds a degree in organizational communications and is a certified Senior Professional in Human Resources (SPHR).
Francisco "Cisco" Perin, Senior Vice President, Technology & Information Strategy
Cisco provides the vision for creation, development, execution, and supervision of all aspects of information technology, strategy, and services for Health Integrated. As a strategist and entrepreneur, Cisco's unique experience in a broad range of industries provides deep vision and value. Prior to joining Health Integrated, Perin founded OmniPACS Inc., a healthcare technology company specializing in global, cloud-based software-as-a-service technologies for medical imaging, and CHILI USA, a distributor of medical imaging software manufactured by CHILI GmbH, Heidelberg, Germany.
You care about people. Not just in the abstract, but as real individuals with real challenges. Perhaps you're a licensed health care professional, or you're just committed to helping people...and highly attracted to health care. Whatever the case, you have a passion for helping others and a commitment to efficiently, effectively create change. You have the energy and instincts to see the whole picture, and make a meaningful difference every day. You’re ready for Health Integrated! Click here to apply today.
The diversity of our team reflects the diversity of the people we serve and support. Health Integrated is an Equal Employment Opportunity (EEO) employer and welcomes all qualified applicants. Applicants will receive fair and impartial consideration without regard to race, sex, sexual orientation, political affiliation, color, religion, national origin, age, disability, veteran status, genetic data, or religion or other legally protected status. EOE M/F/D/V.
For individuals with disabilities or impairments who need assistance with the application process, our HR team is pleased to help. Call 813-388-4000 and ask for an HR representative, or email email@example.com.
To create the health care village where we all come together to care for and protect the most vulnerable and fragile among us.
Be an advocate for the health care needs of the chronically ill and vulnerable by working with health plans to provide these individuals with the information, resources and social support they need to live healthier.
To change the healthcare ecosystem in a significant and positive way by changing the behavior of its participants.
Make the world a better place.
Collaborative and Committed
Since our founding in 1996, Health Integrated has built a reputation as an innovator in the health care industry. That same creativity guides our practice as we guide, engage, motivate and reward our employees. You'll find our culture fosters a collaborative, hardworking and fun environment where professional development, personal achievement and growth are valued, recognized and rewarded. Among our numerous employee-focused programs, you'll find:
Wellness. Protection. Peace of Mind.
At Health Integrated, our commitment to health and wellness extends beyond our members to our employees and their families. Our employees and our business partners collaborate to design wellness programs that are available for all in addition to our generous benefit offerings. Overall, we offer a competitive compensation package including:
Employer-subsidized health, dental and vision plans
Employer-paid life and disability coverage
401(K) Retirement Savings Plan
Flexible Spending Account
Paid Time Off
Click here to apply today.