Payers

Karna delivers solutions to health plans, brokers, and third party administrators.

Health plans have been engaging in Population Health Management (PHM) activities for many years — stratifying group populations by risk, identifying high-cost conditions and enlisting members for participation in disease management programs. However, now payers are collaborating with providers and integrating PHM principles and technologies in an unprecedented approach to curtailing costs and delivering value.

Strategic Consulting

We help payers and brokers navigate rapidly changing employer and compliance environments. We provide senior health professionals that can inform evidence-based programs and advise on specific applications of actuarial data to pragmatic strategies. By applying what is already proven to novel circumstances and working with payers and brokers, we arrive at program designs that innovate and provide greater customer engagement. We provide a repeatable strategic framework from which to launch and sustain multiple platforms.

Evidence-Based Benefits Evaluation and Planning

Karna helps guide payers and brokers in creating benefit plans that address changing customer population requirements.  We provide public health evidence to aid in the process of deciding what health benefits are most effective for particular employers.  Our experienced staff provides a framework for continuous evaluation of effectiveness over time as well as an economic analysis to validate return-on-investment value propositions for payers and brokers.  In all cases, we help link outcomes with scalable sustainability.

Chronic Disease Management Evaluation and Design

We rely on validated approaches to evaluate existing disease management strategies.  We establish appropriate evaluation frameworks and then compare programs to others that are already validated in order to refine or redesign programs to yield greater clinical and cost outcomes.

Healthy Eating Management Program Integration

One of our most common engagements with health plans is helping design programs to measure and engage members in healthy behaviors, often described as weight management. After identifying target populations, we work with our clients to determine the most appropriate healthy lifestyle programs, including self-help, coaching, medical, surgical, and alternative strategies.

Opioid Use Treatment Integration and Coordination of Care

We help design programs to coordinate care, provide community education, psychosocial services, interventions and recovery support to support long term improvements in care.  We also provide a framework to allow for more effective provider collaboration in coordinating care among patients undergoing treatment.  We provide assistance calculating Return-On-Investment valuation of existing and proposed systemic treatment strategies so that payers and brokers can advise employer customers of most sustainable programs.

Patient Engagement and Social Determinants of Health

Karna’s understanding of engaging populations based on where they are born, live, learn, work, play, worship and age enables us to create programs specific to meet their needs. We have seen a dramatic effect on health outcomes by reaching members where they are and creating engagement to impact their health in a manner that is culturally and linguistically appropriate.  By providing evidenced-based approaches to patient engagement, we ensure that the right plans are applied to the right members at the right time and in the right manner.