KnovaSolutions is a personal health service based on the theme “Your Health, Your Decisions.” KnovaSolutions is a clinical prevention service that responds to four consumer needs:

• quality information
• an on-going relationship with a caring health professional
• support in developing and owning a health management plan that promotes self-responsibility
• active participation in medical care decisions

The USA spends considerably more on healthcare (16% of GDP and growing) than any other developed country and receives 23% less value, according to a recent Mercer study. These escalating health benefit costs threaten the financial viability of individuals, families, business and government. Ever increasing medical specialization and technology, coupled with a shortage of primary care physicians, has led to fragmented care, excessive cost, increased health risks and poor outcomes. KnovaSolutions achieves better health at less cost!

High risk and high cost individuals and families….the 5% that use over 50% of health benefits. These individuals have a special need for a trusted and on-going personal health service that informs, educates, and supports their health decisions and prevents further loss of health.

KnovaSolutions clinical staff are advanced-practice, highly experienced nurses and clinical pharmacists. As a team, they deliver information and decision support tailored to the unique needs of each individual and their family.  The service is provided by HCMS Group, a privately-held independent business headquartered in Cheyenne, Wyoming, with clinical staff located throughout the US.

1. The top 5% high-risk / high-cost employees are identified using sophisticated data analytics that incorporate HR, payroll, health/pharmacy and lost time data.
2. These high risk individuals are contacted with a written communication and then telephonically by the KnovaSolutions clinical nurse/pharmacist team, and voluntarily enroll as Knova members.
3. A comprehensive “Health as Human Capital” assessment is performed and a trusted and caring clinical relationship is established during which each member develops a health management plan.
4. Health management plans are implemented, with emphasis on choice and prevention. There are no prescribed management directives: KnovaSolutions is based on listening, caring, clinical information and respect.

HR and payroll data are used to identify high-risk individuals earlier. In addition to health claims data, individual and job demographics, particularly pay for performance and attendance information, are used in the identification process.

• Selective recruitment and intense orientation
• A six-month new staff preceptorship
• Regularly scheduled case review and education sessions involving all staff
• Licensed use of professional on-line and published resources for staff use

Yes. Since KnovaSolutions services are predominantly delivered via telephone and email, many staff provide services from a home office, and are supported by a Contact Center and Operations Center in Cheyenne, Wyoming.  HCMS has deployed state-of-the-art unified communications technology to allow our staff to work together seamlessly to serve members.  Regardless of service location, all KnovaSolutions staff use a centralized service management application and member Electronic Health Record. All data is stored centrally in a secure data center.

KnovaSolutions is a personal health, clinical prevention service delivering cognitive and preventive services that are targeted to the 5% of individuals/families using 50% or more of health benefit costs. KnovaSolutions collaborates with other medical care providers, both primary care and medical specialists, and addresses the health needs of the whole person rather than a disease or health behavior. KnovaSolutions does not operate as an agent of insurance carriers or managed care organizations.

KnovaSolutions membership is initially for one year, and enrollment and continuing membership is voluntary.  Many members do voluntarily extend their membership for multiple years, based on their personal situation and needs.  Most commonly, membership fees are paid by a group health benefit sponsor, such as an employer or government entity. If health benefits eligibility is lost (for example, employment termination) membership is cancelled but direct enrollment is available.

KnovaSolutions is strictly confidential. No personal health data is shared without the member’s written consent and all health information provided is protected by HIPAA privacy standards.

Knova contracts go at risk for identification and enrollment of the 5% high-risk population, followed by guaranteed service levels and Knova member satisfaction. Health benefit cost outcomes evaluation is part of all contracts, comparing Knova Members to a similar at-risk comparison group, and generally show up to a 3:1 savings. If contract size is above 250 Knova Members and if the 5% high risk population is enrolled over at least a 2 year period, risk-gain arrangements are offered based on cost savings outcomes.