Home Health Utilization Management

Healthcare Technology Delivered By A Healthcare Company.

Graham Healthcare Group’s Home Health Utilization Management solution empowers health plans to better manage their home health utilization and network of providers by leveraging quality, utilization, and cost data from the health plan’s existing home health providers.

Based on proprietary algorithms and evidence-based assessments, this customizable solution automates and streamlines the preauthorization process and drives efficiency.


  • Reduced administrative costs
  • Reduced additional documentation from home health clinicians
  • Reduced unnecessary home health utilization
  • Improved patient outcomes and satisfaction
  • Increased provider collaboration and risk-sharing


  • Automated approvals
  • Configurable workflows, validation rules, and decision trees
  • Value-based care modules
  • Outcome tracking
  • Drill-down capabilities
  • Custom reports, trending, and dashboards
  • “Star” ratings reporting based on the health plan’s provider network
  • Identification of high-utilization/hospice/palliative-appropriate patients

Product Overview

Health Plan Care Management Portal

Provides the health plan capability to make authorization requests, review and approve requests, analyze requests, and manage providers.

Home Health Agency Submission and Management Portal

Allows home health agencies to easily upload the patient’s OASIS files and supporting documents to the health plan and provides prompt notification and reporting for the authorization status.

Home Health Performance Portal

Displays outcomes, adverse events, and quality ratings, improving visibility of the home health agency’s overall performance to the health plan.