Our Services and Programs

PDSI provides a full scope of Managed Care Organization/Health Maintenance Organization (MCO/HMO) services:
Wellness Programs
SDOH Services
COVID Testing Services & PPE Products

and Healthcare Management Consulting Services, which are summarized in:

A. SUMMARY OF MCO/HMO SERVICES

    • Member Outreach Programs
    • Health Education and Promotion
    • Provider Network Management
    • Utilization Management
    • Care Coordination and Case Management
    • Grievances and Appeals
    • SDOH and Value Added Services
    • Case Management for Adults with Behavioral Care Needs
    • MCO Administrative and Management Services
    • Predictive modeling and health risk stratification
    • Capitation and risk management
    • Member Services
    • Prevention and Diagnostic Programs

 

  • COVID-19 PCR and Rapid Antigen Testing
  • Children Health Wellness
  • EPSDT Compliance
  • Chronic Disease Management
  • Health Risk Assessment
  • Program Integrity Compliance
  • Quality Management
  • Medical Management
  • Provider Incentive Programs
  • Medical and MCO IT Systems
  • HEDIS and CAHPS Measures Compliance
  • NCQA Accreditation

B. WELLNESS PROGRAMS

The Eight Dimensions of Wellness

PDSI's providers and wellness programs are focused on the following services:

  • Stress reduction programs
  • Weight loss programs
  • Smoking cessation programs
  • Health risk assessments
  • Health screenings
  • Exercise programs and activities
  • Nutrition education
  • Healthy Eating
  • HIV/AIDS Prevention
  • COVID Prevention
  • Alcoholism Prevention
  • Drug Addiction Prevention
  • Family Counseling
  • Self Esteem Development
  • Food Supply Support
  • SDOH Mitigation and Resolution
  • Crisis Intervention Services
  • Health Education and Training

C. SOCIAL DETERMINANTS OF HEALTH SUPPORT AND VALUE-ADDED SERVICES (SDOH)

The Social Determinants of Health (SDOH) are all of the external factors that affect our members’ health and well-being outside of the doctor’s office, and these factors are critical for us to understand our members’ healthcare management needs.

Determinants:

Contributing Social Factors

Food

Hunger, Access to Healthy Food Options, Food Deserts, Access to Healthy Restaurants, Lack of Nutritional Counseling.

Economic Stability

Employment, Income, Expenses, Debt, Medical Bills, Support, Legal Barriers, Job Training

Health Care System

Health Coverage, Provider Availability and Access, Provider Linguistic and Cultural Competency, Quality of Care, Behavioral Services, Homecare, Access to Pharmacy, Program Eligibility Issues.

Neighborhood and Physical Environment

Housing, Transportation, Safety, Parks, Playgrounds, Walkability, Zip Code / Geography.

Education

Literacy, Language, Early Childhood Education, Vocational Training, Higher Education, Computer Skills, Poor Public Schools, Poor Performing Children.

Community and Social Context

Social Integration, Support Systems, Community Engagement, Discrimination, Gentrification, Smoking, Stress, Drug Addiction, Alcoholism. Abusive Relationships

Our SDOH program processes will track the workflow of the Social Determinants of our members’ health and the required social services, program management and coordination needed to remediate and remove these impediments to our clients’ members’ health care.

 

 

D. PRODUCTS AND SERVICES TO PREVENT AND TEST FOR COVID-19

I. FDA Approved COVID-19 Rapid Tests Products provided by PDSI and its approved suppliers include the following brands:

1. iHealth Labs - iHealth COVID-19 Antigen Rapid Test
2. Quick View At-Home OTC COVID-19 Test
3. InteliSawb COVID-19 Rapid Test
4. Acon Labs - Flowflex COVID-19 Antigen Home Test
5. CareStart COVID-19 Antigen Home Test
6. Abbott Binaxnow 195-260 Rapid Test
7. Access Bio – Care Start COVID-19 Home Test
8. Advin Biotech – Advin COVID-19 Antigen Test at Home
9. Azure Biotech – Azure Fastep COVID-19 Antigen Home Test
10. BioTeke USA – Bio-Self COVID-19 Antigen Home Test
11. Cell Trion USA – Celltrion Diatrust COVID-19 AG Home Test
12. Cue Health – Cue COVID-19 Test for Home
13. Ellume Limited – COVID-19 Home Test
14. Orasure Technologies – Intel Swab COVID-19 Rapid Test
15. Pfizer-Lucira Check – IT COVID-19 Test Kit

 

II. In addition, PDSI manages COVID-19 PCR testing services through its licensed laboratory affiliates.


III. FDA Approved PPE Products supplied by PDSI and its approved suppliers:
• N95 Mask (NIOSH approved)
• N95 Mask (Industrial grade)
• KN95 Mask
• Surgical Mask Level I
• Surgical Mask Level II
• Surgical Mask Level III
• Isolation Gown Level I – Disposable
• Isolation Gown Level II – Disposable
• Isolation Gown Level III – Disposable

• Isolation Gown Level IV – Disposable
• Face Shields
• Nitrile Gloves
• Goggles
• Shoe/boot covers (Device Class I)
• Surgical/bouffant caps
• Hand Sanitizer (4 oz bottle)
• Hand Sanitizer (gallon w/pump)
• Disinfectant Spray and Wipes
• Hand Sanitizer, Dispenser

 

PDSI’s PPE products are FDA-approved and many of our PPE and COVID-19 Rapid Test Kits are MADE IN AMERICA.

 

E. HEALTHCARE MANAGEMENT CONSULTING SERVICES

PDSI provides a full scope of health care management consulting in the following areas:

 

SCOPE OF SERVICES OFFERED

  • Management and Operations Consulting
  • Business Planning for Healthcare Organizations and Providers
  • Operations Compliance and Assessment
  • Business Process Re-Engineering
  • Patient Satisfaction Surveys
  • Provider Satisfaction Surveys
  • Management and Organizational Review and Restructuring
  • Operational Reviews
  • Risk Assessment & Risk Management
  • Performance Management Planning
  • NCQA Compliance Reviews
  • Strategic Planning
  • Performance Management
  • HIPPA Compliance Reviews
  • ESPDT Compliance Assessment and Performance Planning
  • DELMARVA Compliance Reviews
  • Systems Implementation Support
  • HEDIS and CAHPS Compliance and Performance Planning
  • Budget Reviews and Planning
  • Change Management
  • Quality Control Training
  • Assessment of Utilization Management
  • Assessment of Case Coordination Functions Assessment of Care Management Function
  • Assessment of Disease Management Program
  • Assessment of Grievance and Appeals Procedures and Compliance
  • Enrollment and Disenrollment Process Improvement Initiatives
  • Assessment of Provider Incentive Payment Plans
  • Assessment of Provider Network Adequacy and Expansion Planning and Implementation
  • Requirements Analysis for Healthcare Management Information Systems
  • Management Training and Conference Planning
  • Regulatory Compliance Reviews in accordance with Health Department Regulations
  • Revenue Enhancement Consulting
  • Cost Containment Consulting
  • Public Health Community Engagement and Community Services Planning
  • HMO Management Services
  • Healthcare Personnel Recruiting
  • Program Management