The healthcare system in United States, when compared to similar nations, is one of the costliest in the world with higher levels of healthcare spending, costlier hospital stays and higher prices of prescription drugs. A major reason for the steady rise in the healthcare expenditure over the years has been the episodic treatment approach that has been prevalent in the US. The need of the hour is for health plans to adopt a more proactive approach. A Shift to Population Health Management (PHM) which is an altered approach, goes beyond episodic care by keeping a target population as healthy as possible. This White Paper covers HCL’s perspective on Care Management 2.0

1. Copyright © 2014 HCL Technologies Limited | www.hcltech.com
White Paper
Care Management 2.0
An Alternative Approach for Population Health
Management

2. 2 Copyright © 2014 HCL Technologies Limited | www.hcltech.com
Rising Healthcare Costs in US has been a business challenge owning to inefficient and episodic
treatment approach by US Health Plans
Steady rise in healthcare
cost
• Episodic Treatment
• Overprescribing of drugs and
tests
System Inefficiencies
• Burdened by improper care and
co-ordination
• Complex administrative
processes
Unwanted Expenditures
• Influx of new memberships from
exchanges
• Healthy population forgoing
health insurance
 The healthcare system in United States, when compared to similar nations, is one of the costliest in the world with higher
levels of healthcare spending
 Healthcare spending is expected to almost double within a decade2 (projected to grow from $2.8 Trillion in 2012 to $5
Trillion in 2022) (Source: National Healthcare Expenditure Projections 2012 – 2022 accessed at http://www.cms.gov/Research-Statistics)

3. 3 Copyright © 2014 HCL Technologies Limited | www.hcltech.com
There is a need for a push for Population Health Management; A Proactive approach adopted by
Health Plans
Health plans to adopt an approach that covers the members having
chronic condition & extending the cover for preventive care - who
have a tendency to develop chronic conditions
Altered approach to healthcare which goes beyond episodic care by
keeping a target population as healthy as possible
The altered approach involves customizing the care modules for the
particular patient
Identify, activate and engage
members
Long term, continued Health
promotion through Customized
wellness and care initiatives
Co ordinated effort of all
stakeholders including members,
Payers and Providers
Ongoing measurement of
progress across various
indicators
A successful PHM Program is built on Four Fundamental Pillars
1 2
3 4Health Situation
Health Goals
Behavior Patterns
Ex. Pre-diabetic Vs Diabetic
Ex. Prevent Chronic Condition v/s
control chronic condition
Ex. Actively manage own health v/s
delays seeking care
An Altered Approach

4. 4 Copyright © 2014 HCL Technologies Limited | www.hcltech.com
HCL’s Approach to Population Health Management is a 2 pronged approach addressing both
existing and new members; Its time for Care Management 2.0
PHM Program for existing members by looking at
Claims Data
PHM Program as a comprehensive voluntary health risk
assessment for new members
HCL’s2prongedapproach
HCLs Six Step Approach to Population
Health Management(PHM)
HCL’s PHM program measures multiple outcome
parameters, which report on the progress across
both the entire population and specific
subpopulations.

5. 5 Copyright © 2014 HCL Technologies Limited | www.hcltech.com
A Shift to Care Management 2.0
DOWNLOAD THE WHITE PAPER TO UNDERSTAND HCL’s APPROACH TO CARE MANAGEMENT 2.0
The healthcare system in United States, when compared to similar nations, is one of the costliest in the world with higher levels of healthcare
spending. A major reason for the steady rise in the healthcare expenditure over the years has been the episodic treatment approach that has
been prevalent in the US. The need of the hour is for health plans to adopt a more proactive approach. A Shift to Population Health
Management (PHM) which is an altered approach, goes beyond episodic care by keeping a target population as healthy as possible. This
White Paper covers HCL’s perspective on Care Management 2.0
1. What is making healthcare cost rise in US?
2. What is the approach and a technology path that a Health Plan needs to adopt so as to stay profitable and customer friendly?
3. How can a technology service provider help me take an alternative route to reduce the rising healthcare costs?
4. HCL’s unique approach to Altered Population Healthcare Management (PHM) – Care Management 2.0 will help US health plans to emerge from this
challenge of rising costs