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​​Healthier Employees = Healthier Bottom Line

KelseyCare Health Plans understands the healthcare needs of employers and employees; that's why we offer plan options that benefit both.

We leverage the accountable care model of Kelsey-Seybold Clinic to deliver programs including preventive care and disease management to keep employees healthy and performing at their best.

By connecting businesses and employees with a growing healthcare network in the Houston area, KelseyCare has uncovered a proven method that allows businesses to reduce total medical costs. This unique approach allows us to create better outcomes for companies and an overall better healthcare experience for every patient we see.

Our Approach: Coordinated, Accountable Care

KelseyCare is designed to deliver a better, more affordable, high-quality healthcare experience. In KelseyCare health plans, primary care physicians and specialists work together as a team. We know that provider collaboration helps make healthcare more effective. This “coordinated care” model has been pioneered by Kelsey-Seybold since 1949. It’s proactive, focused on prevention and early intervention on disease. It’s powered by information-sharing through our comprehensive, connected Electronic Medical Record system. It’s supported by exclusive, physician-designed clinical programs including Disease Management, Care Management, and Site of Care Management. Through KelseyCare, benefits and state-of-the-art care delivery are integrated to deliver better outcomes - higher prevention and disease management engagement. A lower total medical cost. Higher member satisfaction scores. We’ve proven that when employers offer the KelseyCare plan option based on coordinated care and integrated clinical programs, the result is not only healthier and happier employees, but a reduction in total medical cost through this innovative care model.

Coordinated engagement

All providers share information so there’s no need for duplication. We also have teams to reach out when you’re due for a visit or testing.

Capitated vs. FFS

KelseyCare is based on capitation. In capitation, the provider organization is Responsible for organizing and delivering comprehensive healthcare, Quality outcomes, member satisfaction, and the total cost of care. Capitation fuels clinical innovation. It empowers physicians to create care programs that improve quality – like integrated Disease Management, Case Management, Nurse Triage, Rapid Treatment Center, E-Consults, and the Hospitalist Physician Team. These directly impact quality of care.

Fee for Service reimbursement pays for episodic care. It doesn’t provide the Resources for clinicians to systematically develop and drive improvement in Care delivery.

Seeking better outcomes

Doctors are evaluated by outcomes and better health. Our integrated programs work to prevent health issues before they start.

Our Model Aims to Support Cost Containment through:

Reducing duplication – Why waste? It’s as simple as that. Instead of multiplying X-rays and lab work, our team works in sync to ensure patients only get procedures exactly when you need it – nothing more, nothing less.
Increasing preventive care – Preventive care just makes sense. We think every person should receive care early enough to catch health issues before they become severe or life-threatening.
Improving disease management – From diabetes to congestive heart failure, diseases such as these call for proactive, consistent care. Our care management team reaches out to patients for scheduling, making lifestyle choices, and improving symptoms.