Specialty Care Management

🚨 Renewal season is here! At Specialty Care Management, we understand the challenges self-funded health plans face, especially with kidney disease affecting over 35 million Americans (1 in 7 U.S. Adults). As the industry leader in mitigating the financial and human costs of dialysis and CKD, we partner with health plans of all sizes to: ✔️ Control active costs ✔️ Mitigate future risk ✔️ Improve overall population health Plus, our engagement model is simple and transparent: ZERO implementation fees and NO % of savings charges. What's more, enrolled plans often see enhanced stop-loss renewals, including reduced or eliminated lasers. Let's get to work. Meet with our team for a complimentary discovery call --> https://lnkd.in/evxCepGu #SpecialtyCM

✨ As we head into 2025, Specialty Care Management is excited to continue leading the way in improving member health and controlling costs for self-funded health plans. With kidney disease affecting 1 in 7 adults in the U.S., and with ballooning dialysis costs, it's never been more urgent... We’ve put together 13 New Year’s Resolutions —practical steps to cut costs, improve member outcomes, and build sustainable risk mitigation plans. ✔️ Stop accepting low PPO discounts on renal dialysis claims ✔️ Say no to percentage-of-savings fees ✔️ Embrace innovative cost-containment solutions ...and more. Meet with us and let's get to work: https://lnkd.in/e9XT-H58 We value the opportunity to work together. Happy New Year from all of us at SCM. #SpecialtyCM #HappyNewYear

🎅 This year, Santa’s got his priorities straight. And he's delivering more than just gifts—he’s teaming up with Specialty Care Management to tackle 2025's top challenges for self-funded health plans. From lowering cost trends to improving member outcomes, Santa’s Delivery List is packed with essentials to protect plan assets and enhance care. But is your health plan on the list? Whether you’re celebrating or not, let’s connect to ensure your health plan gets everything it deserves this Holiday season and into the new year. Schedule a complimentary discovery call with us this January -- https://lnkd.in/e9XT-H58 Happy Holidays from all of us at SCM. #SpecialtyCM

Happy Holidays from Specialty Care Management! 🎉 As the year comes to a close, we want to take a moment to express our gratitude to our clients, partners, and team members. Your trust and collaboration drive us to make a meaningful impact every day. Please note our adjusted Holiday hours: 🎁 Christmas Eve (Tuesday, December 24): Closing early at 2:00 PM 🎁 Christmas Day (Wednesday, December 25): Closed 🎉 New Year’s Eve (Tuesday, December 31): Closing early at 2:00 PM 🎉 New Year’s Day (Wednesday, January 1): Closed Thank you for being part of the SCM family. We look forward to continuing to work together in 2025 and wish you a season filled with joy, warmth, and gratitude. #HappyHolidays #SpecialtyCM

💡 Dialysis and Kidney Disease Management: A Case Study in Savings and Member Care At Specialty Care Management, we proudly partner with self-funded health plans to tackle the human and financial costs of dialysis and kidney disease—conditions impacting 37 million adults in the U.S. Here's a recent example: -- The Challenge: A Taft-Hartley Fund managing five dialysis patients monthly faced exorbitant (and escalating) costs, even with a 20% PPO discount. SCM stepped in to help. Our team conducted a complimentary Summary Plan Description review and a Renal Risk Assessment, uncovering cost-saving opportunities and actionable strategies. -- The Solution: SCM implemented its Dialysis Cost Containment and CKD Management Program, featuring: ▶️ Data Analytics: Early intervention and ongoing insights to reduce dialysis risk and address pre-dialysis conditions and comorbidities. ▶️ Strategic Nurse Coaching: Personalized education and care coordination. ▶️ Cost Containment Strategies: Industry-leading case rates and customized solutions. -- The Results: ✔️ $3.7 million in savings off initially billed charges. ✔️ No disruption in member care. ✔️ Zero additional out-of-pocket costs for members. Impressed? We're just getting started... Connect with the best team in the business to explore how we can help your health plan achieve similar savings in 2025, safeguard plan assets, and improve population health --> https://lnkd.in/e9XT-H58 #SpecialtyCM #KidneyDisease #CostContainment

🎉 Celebrating Our Team’s Milestones At Specialty Care Management, we’re proud to recognize the dedication and hard work of our incredible team members as they reach significant career milestones: Lyndsi Carter – 4 years (12/17/2020) Jessica Felter – 3 years (1/3/2022) Steve English – 1 year (1/8/2024) Thank you, Lyndsi, Jessica, and Steve, for your dedication, hard work, and for being an essential part of our exceptional team.

💡 Fast Facts About Kidney Disease Kidney disease affects millions of people in the U.S., yet it often goes undetected until it’s too late. The impact is staggering: ✔️ Millions are at risk. ✔️ Early intervention can save lives and reduce costs. ✔️ Education and proactive care are crucial.   At Specialty Care Management, we’re committed to raising awareness of kidney disease, providing innovative solutions to improve outcomes for those impacted, and effectively mitigating risk and containing costs for self-funded health plans.   Let's get to work. Meet with us to learn more how we can safeguard your health plan and improve member health: https://lnkd.in/evxCepGu   #SpecialtyCM #KidneyDisease

Health plans often think an in-network 10-25% discount on dialysis claims is a win. But let’s face it— with average dialysis claims well into the 6 figures, that’s not a game-changer. At Specialty Care Management, we’re here to rewrite that script. Our Dialysis Cost Containment Program helps health plans secure significantly deeper discounts—often up to 85% off paid claims—while improving member health outcomes. Here’s how we get it done: 👍 Expert Claims Negotiation & Underwriting Model: Leveraging top talent in Healthcare Administration, Clinical Case Management, and Provider/Payee Contract Law to maximize savings. 👍 Strategic Nurse Coaching: Supporting plans and members to achieve better health outcomes and reduce costs. 👍 Complimentary Data Analytics: Ongoing actionable insights for enrolled plans to identify early intervention opportunities and cost drivers. 👍 Proven Results: Year after year, we deliver measurable savings and exceptional member care. Why settle for some savings when you could achieve game-changing results? Let's connect and explore further --> https://lnkd.in/evxCepGu #SpecialtyCM #DialysisCostContainment #CKD

🚨 Dialysis Claims: A Growing Challenge for Self-Funded Health Plans With 1 in 7 US adults facing kidney disease, the stakes have never been higher for health plans managing skyrocketing dialysis costs. Every dollar saved makes a difference. In the case study outlined below, Specialty Care Management delivered a remarkable $568,300 in savings for a Captive group—achieving a 90% reduction off paid charges on a single active dialysis case... 💡 The Challenge: - Initial provider billed charges: $841,333 - Network discount reduced liability to $631,000 (just 25%) - Pushback from the network, despite carve-outs being allowed 💡 The Solution: - With SCM's Dialysis Cost Containment Program, we reduced the plan's liability to just $62,700—delivering $568,300 in savings with no % of savings fees. We're proud to continue to lead the industry in addressing these high-cost challenges for self-funded health plans, offering tailored solutions that reduce active costs, mitigate future risk, and improve overall population health. Let’s get to work. Click here to schedule a complimentary discovery call and receive a FREE Renal Risk Assessment for one or all of your groups --> https://lnkd.in/eVwxPcUd #SpecialtyCM #DialysisCostContainment #KidneyDisease

Specialty Care Management would like to take a moment to wish our colleagues, partners, and clients an enjoyable Thanksgiving holiday.   Please note that our offices will close today, Wednesday, November 27th, at 2 PM EST in observance of the holiday and will reopen on Monday, December 2nd.