Annapolis, MD (PRWEB) November 21, 2013
Pulse8, LLC - a cutting-edge big data and healthcare analytics company focused on Risk Adjustment solutions for the Health Insurance Marketplace announced today that Blue Cross Blue Shield of Kansas City (Blue KC) has chosen Pulse8’s Risk Adjustment Analytics and Technology products, as well as its Risk Accuracy and Mitigation products for its Commercial Health Insurance Marketplace population.
Pulse8 will implement its Reveal8™ risk adjustment analytic solution to drive precision and accuracy into Blue KC’s Commercial Marketplace population applying unique Member and Provider Profiling so that Blue KC can quickly assess and assist its individual members in finding the most appropriate care, ultimately closing documentation gaps and improving quality. Reveal8™ will monitor the 3Rs (reinsurance, risk corridor, and risk adjustment) enabling Blue KC to easily measure financial performance.
“Blue KC will gain valuable insight into our population through Pulse8’s Business Intelligence tools and dashboards,” said Jason Grau, Vice President of Enterprise Strategy at Blue KC. “Pulse8’s solutions will further assist us with identifying the appropriate outreach to our physicians and members, to ensure access to the right care at the right time.”
Pulse8’s Detector8™ product will provide Risk Accuracy and Audit Readiness ensuring Blue KC is prepared, with key features such as: analysis of conditions most susceptible to documentation issues, identification and prioritization of condition sources, and provider specialty patterns and sequencing for inappropriate diagnoses.
“Blue KC’s mission is to improve the health and wellness of its members. Pulse8 is honored to be a part of this mission,” said John Criswell, Pulse8 CEO.
About Blue Cross Blue Shield of Kansas City:
Blue Cross and Blue Shield of Kansas City, the largest not-for-profit health insurer in Missouri and the only not-for-profit commercial health insurer in Kansas City, has been part of the Kansas City community since 1938. *Ranked by J.D. Power and Associates in 2013 as “Highest Member Satisfaction among Commercial Health Plans in the Heartland Region, Two Years in a Row,” Blue Cross and Blue Shield of Kansas City provides health coverage services to more than one million residents in the greater Kansas City area, including Johnson and Wyandotte counties in Kansas and 30 counties in Northwest Missouri. Our mission: to use our role as the area's leading health insurer to provide affordable access to health care and to improve the health and wellness of our members. Blue Cross and Blue Shield of Kansas City is an independent licensee of the Blue Cross and Blue Shield Association. For more information on the company, visit its website at BlueKC.com.
- Blue Cross and Blue Shield of Kansas City received the highest numerical score among commercial health plans in the Heartland region (AR, IA, KS, MO, NE, OK) in the proprietary J.D. Power and Associates 2012-2013 U.S. Member Health Plan StudySM. 2013 study based on 33,533 total member responses, measuring 11 plans in the Heartland Region (excludes Medicare and Medicaid). Proprietary study results are based on experiences and perceptions of members surveyed December 2012-January 2013. Your experiences may vary. Visit jdpower.com.
Pulse 8 is a cutting-edge big data healthcare technology and analytics provider that delivers an unprecedented view into risk adjustment so health plans can achieve the highest financial impact in the Commercial Health Exchanges. Its proprietary algorithms move beyond traditional methods and data sources to make predictions about what individual members require next, ultimately closing gaps in care and increasing precision with risk adjustment initiatives. Pulse8 offers innovative and unique methodologies to ensure its clients outperform the marketplace. Its transparent and flexible business intelligence tools give real-time visibility into member and provider behaviors allowing clients to apply the most cost-effective and appropriate interventions. Pulse8 Every Number is a Life™. For more information, please visit http://www.pulse8.com