Complete ACO Solution

 

Health Exchange (HX)- The HX module enables ACOs to manage and improve key indicators of success on the ACO, physician, and patient level. Using the HX Module, ACOs can:

• Manage beneficiary attribution.
   - Track and manage fluctuation in quarterly patient assignment.
   - Track and manage data sharing preference of patients by physician.

• Maximize HCC Risk Score.

• Provide actionable data that identifies Quality Gaps.

• Track and manage total and location-specific utilization to identify areas for improvement.

 

 

Case Management (CM) - The CM module increases the efficiency of care teams through:

• High-risk Patient Identification: Risk stratifies beneficiaries to identify high-risk patients with conditions that respond well to case management.

• Condition-Based Interventions: Employ evidence-based interventions designed with input from our physician advisory board.

• Workflow Optimization: Our easy-to-use platform makes documentation and scheduling a breeze. Having all information in one system reduces data collection and streamlines care transitions between different members of the care team.

 

 

Complete CCM Solution

 

Chronic Care Management (CCM)

• Identification of Eligible Patients.

• Easy-to-use application to effectively manage CCM patients per Medicare requirements.

• Patient-specific care plan based on patient's chronic conditions.

• Weekly patient summaries.

• Weekly Billing Reports.

 

 

Patient Portal

• Secure, 24/7 access to medical records.

• Bi-directional collaboration between patients and care team.

 

 

Available Care Team

 

Don't have the staff to provide CCM Services? We have you covered. We offer the following.

 

• Certified health personnel.

• Provision of CCM services (e.g. phone calls).

• Documentation of CCM services.