Health plans cannot afford the risk of receiving delayed or missing information that is required from their providers. With a provider analytics solution, a new model emerges: care gaps, based on changes to a member's health status, are updated daily and can be viewed by the caregiver immediately.
IRVINE, Calif. (PRWEB) July 17, 2019
Dynamic Healthcare Systems, a leading provider of enterprise-wide solutions to health plans participating in Medicare Advantage, Medicaid, and Marketplace programs is pleased to announce the introduction of an expanded Risk Analytics solution for Providers featuring Electronic Health Records (EHR) integration at the point of care to providers and provider groups participating in value-based and risk-share services with Medicare Advantage Organizations (MAOs).This new Provider Analytics solution further complements Dynamic's End-To-End Risk and Care Management offering for MAOs.
Since the introduction of risk-adjustment for Medicare Advantage, Dynamic has established a reputation for its risk-based analytics for Medicare Advantage Health plans. Dynamic utilizes the wealth of clinical data collected to construct organized information for the focus of a provider, and is capable of embedding member-based information directly to the provider’s Electronic Health Record at the point of care.
The payment landscape is rapidly shifting due to the fee-for-services declining while value-based care is increasing. Such changes are moving down to the provider level, where the quality of data can affect both revenue and patient care. Working together as a team, health plans and providers can offer access to timely risk adjustment and quality scores data in a much more efficient manner and while the data is still actionable.
Under the old (non-Dynamic) model, risk analytics are delivered to health plans online, and through them, to their provider networks – usually in the form of paper reports. This information is received by the provider either well in advance or well after the actual encounter with the patient. To complicate the process even further, even if the information were available to help inform the provider, documenting both health diagnosis and care gap closure usually requires multiple systems, multiple log-ins, and multiple processes that extend well after the encounter is over. The information is not updated until the documentation produces a bill that is adjudicated and then updated throughout the system.
“Health plans cannot afford the risk of receiving delayed or missing information that is required from their providers,” says Jim Corbett, Chief Strategy Officer. “With a provider analytics solution, a new model emerges: care gaps, based on changes to a member's health status, are updated daily and can be viewed by the caregiver immediately in the medical record.”
Dynamic Healthcare Systems has streamlined this entire process by deploying a solution that achieves semantic interoperability between payers and provider systems. Algorithms are applied to model risk and performance scores on current data, and provide outcomes where it can have the quickest and most meaningful impact – at the point of care.
Timely data can also decrease Risk Adjustment Data Validation (RADV) issues. With an integrated process, organizations should see improved documentation with fewer retrospective chart reviews required, allowing health plans to gather and analyze information faster, pinpoint where chart reviews are needed to protect themselves from under and over reporting, and help identify risk and care gaps earlier.
Whether you are a health plan, management services organization, or large at-risk provider group, Dynamic’s risk analytics application is designed to improve capture rates of diagnosis and quality measures to provide better information to your providers and as a result, better care and increase in revenues.
About Dynamic Healthcare Systems
Dynamic Healthcare Systems is one of the very few end to end providers of enterprise-wide solutions to health plans participating in Medicare Advantage, Managed Medicaid, and Marketplace programs. Dynamic’s solutions help its clients optimize plan revenue and quality through the utilization of Dynamic’s rich analytics that identify areas for potential improvement, help maintain compliance through ongoing enhancements aligned with CMS regulations, and enhance operational efficiency through fully integrated solution utilizing a centralized database and integrated workflows. Headquartered in Irvine, California, the company offers comprehensive software solutions, managed services, and professional services. For more information, visit dynamichealthsys.com or call 949.333.4565.