Provider Organizations including ACOs, CINs, IPAs, IDNs

As the value-based care market evolves, progressive organizations will continue to implement strategies that optimize shared savings across multiple revenue streams and mitigate downside risk. Leaders focused on developing these approaches will need the right technology in place to achieve success.

Optimizing Population Health

To manage multiple value-based revenue streams with different optimization strategies, organizational leaders must have a comprehensive understanding of the patient population. HealthEC aggregates and centralizes all electronic data on a single platform, and applies decision support analytics to identify risk and stratify the patient population. Informed leaders are better equipped to remove barriers to care, redefine care coordination, better manage ambulatory care access, evolve urgent/emergent care models and mitigate the impact of social determinants of health, across all payment programs:

  • Private Payer and Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs)
  • CMS quality programs such as Comprehensive Primary Care Plus (CPC+), Oncology Care Model (OCM), Chronic Care Management (CCM), Annual Wellness Visits (AWV)
  • Medicaid Health Homes

Improving care delivery through population health management requires strategies that incorporate clinical service coordination through performance measurement, process improvement, outreach and patient engagement, episodic care coordination, care transition management, chronic disease management, and pharmacy management. HealthEC’s comprehensive approach provides programs and services to all health care organizations:

  • Keeping patients healthy and loyal to the system through portal and mobile outreach for preventive care
  • Avoiding unnecessary care for at-risk patients by connecting members with risk modification services and the office-based care team
  • Managing rising-risk patients through medical home services and active care management
  • Intervening with high-cost high-risk patients through centralized care management

Providing Consulting Services to Drive Value-Based Care Initiatives

As a pioneer in population health management, HealthEC’s subject matter experts provide advisory services to help manage a variety of initiatives, including:

  • Determining ownership and governance
  • Organizing physician groups and services
  • Understanding cost and performance across providers and services
  • Aligning incentives with new models that create a win-win structure and scale with performance
  • Developing strategies to address the entire continuum of care
  • Designing advanced care delivery models
  • Promoting patient engagement through empowerment and shared decision making
  • Creating cost and quality transparency
  • Marketing results to payers for preferred partnerships

With access to a comprehensive data warehouse and industry-leading analytics tools, HealthEC helps organizations manage their ongoing CMS initiative-related performance. As a 2018 CMS-approved Qualified Clinical Data Registry (QCDR) capable of submitting data for organizations under the Group Practice Reporting Option (GPRO), HealthEC’s advanced analytics and GPRO audit tools capture all required quality measure data fields for each assigned Medicare beneficiary, eliminating manual tasks and dramatically simplifying the submission process.

HealthEC provides the critical infrastructure to support value-based care:
  • Gain insight about your patient population
  • Align incentives to promote quality
  • Focus the team on removing barriers to care
  • Develop care delivery models that drive quality across all patient populations
  • Optimize health plan contracts by clearly articulating service value