Aggregate, Risk Stratify, Automate, Collaborate and Engage
The shift from fee-for-service to value-based reimbursement models is underway making intuitive and proactive member care programs vital to quality improvement and overall cost reduction.
To be successful, organizations accountable for quality across all sites of care must:
- Aggregate members’ claims and clinical data from all sites of care
- Normalize and analyze data for risk stratification that supports predictive decision-making and deployment of resources
- Manage communications that drives collaboration among all care providers
- Engage members in care activities
We provide next-generation risk stratification, rules-driven CareFlow™ Automation with embedded analytics that use claims and clinical data to create and manage optimized care flows. This allows health plans to enable and manage all stakeholders in alignment with population based quality programs. Our highly customizable platform includes end-to-end HEDIS® solutions, case management coordination, population engagement and management solutions.
- Sponsored by those accountable for quality and costs
- Provider aligned
- Member centric
- Drives accountability, transparency and collaboration among stakeholders