Dennis Graziano, CEOMonroe Plan for Medical Care is uniquely qualified to help other organizations achieve the goal of balanced care while meeting ever-increasing regulatory requirements.
Monroe Plan for Medical Care is a non-profit healthcare organization with over 50 years of experience helping individuals and families dependent on government-sponsored health insurance. Providing a full suite of population health management services, Monroe Plan’s expertise includes care management, utilization management, and an advanced healthcare analytics and reporting platform designed to support value-based arrangements focused on medical cost management and quality care.
Monroe Plan has a robust, NCQA accredited Utilization Management Program that efficiently conducts pre-service, concurrent, and post-service reviews for all categories of Medical and Behavioral Health services. In addition, Monroe Plan is a registered Utilization Review Agent through the New York State Department of Health.
Monroe Plan consistently uses national, best-practice, evidence-based criteria for reviewing all services. As a result, the reviews conducted by Monroe Plan receive 100% Inter-Rater Reliability scores and yield superior performance on chart and regulatory audits. Prior authorizations and customer support are provided by a best-in-class call center operation that consistently meets or exceeds all customer service level agreements and metrics such as speed-to-answer and first-call resolution.
Monroe Plan brings a unique and comprehensive understanding of the healthcare landscape to their Utilization Management programs. In addition to offering services to other healthcare organizations, Monroe Plan operates an Independent Physician Association (IPA) affording their team a provider perspective on healthcare-related issues. With previous experience operating a health plan and current management of a leading care management agency in New York, Monroe Plan’s has a 360-degree, first-hand understanding of the challenges that healthcare organizations face today. When it comes to utilization management, this broad experience makes it easy for Monroe Plan to identify cost trends, design interventions to address the areas of improvement, and guide clients on how to move forward.
“We recognize utilization trends and work with our partners to implement best practices to implement cost effective solutions and quality outcomes,” says Kim Hess, COO at Monroe Plan for Medical Care.
We recognize utilization trends and work with our partners to implement best practices to implement cost effective solutions and quality outcomes
Monroe Plan’s overarching mission is to support individuals served by government sponsored programs to improve their health status. By serving this mission, Monroe Plan has made a real difference in improving health care disparities for highly challenged populations in the communities we serve. In so doing, we have built broad expertise managing the quality and cost of care for medically complex populations that healthcare organizations of all types will find beneficial.
