Unique Clinical Data to Success
Unique Clinical Data to Success
There is some very unique and cool info here.
There is some very unique and cool info here.
There is some very unique and cool info here.
There is some very unique and cool info here.
Improving Care Coordination & Care Management
Payers and providers need to coordinate the care received by their patients and members. Access to clinical data in a unified care record allows care management and case management to have shared insights, which can include a shared care plan. Alerts regarding inpatient and ED admissions to both the PCP and the payer allow better coordination for the patient, and automatic enrollment into care management programs. Additionally clinical data can populate CM/UM systems assuring current and accurate information.
Enhancing Quality & Streamlining Measurement
Improvement happens continuously, not 90 days ago. In order to both measure and improve quality measures such as HEDIS and STARS, real time clinical data can provide almost up to date data to measures which allows continuous monitoring and improvement. NCQA recently created a draft specification to expand HEDIS measurement to support clinical data.
Optimizing Network Performance
As a health plan, your greatest asset is your provider network. The more they provide cost effective quality care to members, the better it is for everyone. The key to that is transparency in data sharing, allowing them to see how they are performing against value based contracts; giving them insight into a longitudinal view of the care record; helping them to succeed.
Making Operational Processes
Reimagining payer operations means using clinical data to make processes more efficient. Often those processes involve both the payer and the provider. Examples include automation of prior authoritzation and UM, complaince with state or federal programs such as lead screening compliance, or eliminating the HEDIS chart chase.
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