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Managed Healthcare

Managed healthcare

PPSHA’s managed healthcare encompasses clinical and financial risk management of healthcare, with a view to facilitating appropriateness and cost effectiveness of relevant health services within the constraints of what is affordable, using rules-based and clinical management-based programmes.

In recent years, the focus for managed healthcare has moved away from just providing a service or cutting costs to ensure quality outcomes which is a measure of healthcare efficiency. PPSHA’s aim is to ensure appropriate healthcare expenditure while improving patient outcomes.

The clinical protocols are fully integrated with the IT managed care solution which includes built-in workflow, e-mail and SMS messaging, online webchat, business intelligence tools, integrated multi-media and document management

We offer the following Managed Healthcare Services:

  • Hospital Benefit Management
  • Clinical Auditing
  • Clinical Committee Review
  • Clinical Risk Reporting
  • Network and Provider Contracting
  • Provider Negotiations
  • Disease Risk Management
Disease Risk Management

Disease Risk Management focuses on a patient holistically and not just managing specific chronic conditions. All aspects of their health are managed to prevent related hospital admissions.

PPSHA is accredited for these CDL conditions:

  • Asthma / COPD / Bronchiectasis
  • Cardiac Failure / Cardiomyopathy / Dysrhythmias / Coronary Artery Disease
  • Diabetes (Type 1 and 2)
  • Hyperlipidaemia
  • Hypertension
  • Mental Health Services
  • HIV
  • Chronic Renal Disease