Our goal at SCM is to develop effective, value-added strategies to manage the most catastrophic healthcare claims. In practice, we significantly reduce the overall costs of care for self-funded health plans. Widespread adoption of our cost management solutions throughout the continuum of risk services helps minimize costs and thereby improves each client’s bottom line. Since 2002, our visionary insight continues to guide the development of our industry-leading products and services. We are proud of the success our programs have achieved over the years, and are dedicated to evolving and delivering innovative cost-saving products to the self- funded market.
How we represent ourselves to our clients matters. When they hear the name “Specialty Care Management,” what is it we want them to think of? Innovation? Savings? Risk solutions? Or all of the above? We created this brand promise to ensure that our message and our mission always remain clear, both to our clients and to ourselves as a company.
WHO WE ARE
Specialty Care Management (SCM) provides an innovative risk solution that normalizes claim costs and brings them back under control. Specializing in program designs for renal claims, cancer management, transplants, clinical underwriting consulting and negotiation services, SCM helps clients reclaim their claim spend and experience maximized savings every time.
WHAT WE DO
We make it simple for our clients to save. When dealing with something as complex and confusing as high-cost insurance claims, simplicity is key. At its core, our solution is so simple and straightforward in that it completely pays for itself. No guesswork, no games—just normalized claim costs that are consistently under control. And with no set-up fee or cost until utilization, it’s a no-brainer—SCM is the smartest move clients can make for their high-cost claims.
HOW WE DO IT
Normalize, don’t compromise. With industry-exclusive tools as the foundation of our programs, we normalize claim costs for our clients, bringing their costs under control and putting them back in the driver’s seat.
Our exclusive flat case rate option guarantees that you are never subjected to the risk of inflation—plus we double your savings compared to typical network solutions.
With unique differentiators for certain programs that include a flat case rate, fiduciary responsibility, medical expense protection, and an all-encompassing fee structure we are able to be proactive rather than reactive when helping our clients manage their high-cost claims.
Providing Innovative Products & Services to Manage High-Cost, High-Risk Healthcare Claims, Including Renal Dialysis Cost Containment, Oncology Case Management, and Organ Transplant Management.See How We Can Help You
What Our Clients Are Saying:
I have worked with Mike Madden from SCM for the past year and found him to be very professional, competent, reliable, knowledgeable, and a very flexible colleague to work with. His extensive knowledge of medical underwriting and medicine is very evident in his concise and clear medical review reports plus all reports are returned within […]
Prodigy like most stop loss carriers has been plagued with runaway costs associated with dialysis treatment for our ESRD patients. Like many of our colleagues, we struggled to understand the cost variations among our patient population even when treatment regimens and settings were the same. In an effort to control the dialysis exposure, we searched […]
We have worked with Specialty Care Management for many years on behalf of our clients. They have saved our clients hundreds of thousands of dollars. Their high level of expertise and consultative services have provided us and our clients with a turnkey approach in the management of services including dialysis and cancer management. We recommend […]
In addition we know the client will get the quick response, education and service needed and most importantly the savings. I can recall one instance where we acquired an account not because our rates were the lowest, but because the group was impressed by our introduction of SCM ,learning of their savings ability and service.I […]
SCM helped me with “the obscene cost of dialysis…” and has “reduced the cost for our clients and has minimized the lasers at renewal.” SCM is “easy to work with” and there was “no real push-back from the providers once we show them the document wording.” Clients “will appreciate the results and experience.
We have been working with SCM services since 2011. We have found SCM Services to be an added value to our stop loss product. Our needs, in particular, are to control the ESRD claimant with high cost hemodialysis. When a client is presented with a $500,000-$600,000 separate specific deductible on a hemodialysis claimant there is […]
Specialty Care Management has been a real partner. Using Specialty Care Management services the reinsurance carrier reduced the lasers on those employees to an affordable rate. SCM was able to re-price the claims to an amount that would allow the County to keep their employee health plan. The re-priced amount kept the employees with the […]
Our third party administration firm serves a diverse population with a portion of that population predisposed to certain disease states which lead to renal failure and subsequent dialysis services. Due to the very high cost associated with dialysis our company was seeking a solution for those rapidly rising costs. In 2011 we performed a due […]
We had a client that was a small County Government and they had two employees diagnosed with End Stage Renal Disease. This diagnosis would require the employees to seek renal dialysis as a treatment. When the reinsurance carrier for the County’s health plan saw that diagnosis and treatment plan they were going to impose two […]
5860 Lower York Road
Building 3, Suite G