With Continuous healthcare quality improvement
Expected time and cost reduction in coding and chart retrieval as a result of artificial intelligence (ai) and machine learning.
Expected increase in efficiency and effectiveness of your risk adjustment program management.
Expected provider engagement improvement.
TheHealthcare360™ is the first company to dramatically lower the barriers of entry and the operating costs of a value-based operational model for Health Plans, IPA’s/Physician Groups, and Health Systems.
Payers (MA, ACA, Medicaid)
Independent Provider Associations
Hospital/Health Systems
Few Health plans and IPAs can afford the in-house expertise on a full-time basis to understand and manage the data and programs consistently.
Complications include:
Annually changing CMS rules, which has to be reviewed, interpreted, translated, monitored
Need qualified and affordable IT, technical resources
Need qualified SME's to manage the program consistently
Most importantly, accurate financial and quality related information is essential in guiding the Healthcare organization where to focus limited resources for the best patient/member care possible.
Opportunities exist if you can:
Easily and consistently identify areas of high and unnecessary utilization to be used for provider education and cost management
Quickly and consistently stratify membership classifications and stratify risk appropriately for program development and monitoring
Create a reliable shared view of data between the health plan and providers
Introducing ”Better Patient care + Increased Revenue + Optimized Costs“
An Interactive, fully integrated, AI-Based solution for accurately identifying RAF score and providing real time actionable insights on quality gaps. The tool empowers the stakeholders to not just identify the gaps but to track the progress and close these gaps.
