Improve Outcomes and Increase Revenue
Bundle Claims in Real Time
Scale prospective bundled payment programs
With real-time visibility into episode activities, payers can influence the outcomes of active episodes. Our Episode Management product helps you develop, manage, and scale prospective bundled payment programs, working within your current claim workflows to automate value-based programs.
As a result, you're able to scale your programs by bundling claims in real time, as they come in. The flexible system uses claims adjudication logic to help you increase bundled payment auto-adjudication.
Manage Alternative Payment Models
Reduce costs with configurable analytics
Monitoring alternative payment models is time-consuming and complex. Our HealthQx is a software as a service (SaaS) healthcare analytics platform designed to simplify the design and administration of bundled payments, ACOs and other at-risk arrangements.
HealthQx is a certified HCI3 Prometheus Analytics platform that helps you reduce medical costs by increasing clinical efficacy, improving over and under-utilization, and more. Drill-down dashboards support provider engagement and contract negotiation.
HealthQx helps customers reduce administrative tasks for value-based payment programs by approximately 20-30%.
Develop a Care Coordination Program
Improve care quality and patient engagement
Approximately 93% of Medicare spending is on beneficiaries with multiple chronic conditions. Time constraints make it difficult for providers to manage this population, especially between office visits.
Our care coordination services can help you improve patient engagement and quality of care, while receiving payment through the CMS chronic care management program. Our services help you meet CMS billing requirements for chronic care management, complex chronic care management, and the Merit-based Incentive Payment System (MIPS).
Achieve Better Outcomes
Manage your ACO business
Our Accountable Care Services consultants guide you through initial applications and contract negotiations and provide daily operational management assistance. Services include care coordination and utilization management; claims, finances, and call center management; and provider aggregation, care-quality management, and reporting.
Our advanced data warehouse and decision support tools, including population health management, can help you ensure patients receive the care they need.