Value Based Care
Clinical Performance Analytic
Value Based Care
Clinical Performance Analytic
Simplify the identification of consumer gaps in care, enabling providers to seamlessly identify and act to close gaps in real-time.
80% of plans, including the Centers for Medicare and Medicaid Services (CMS), are moving toward value-based payment arrangements (VBC). This shifts risk from payors to practitioners and urgently requires transition to a value-driven practice. Providers have the cumbersome task of assessing each consumer’s risk, identifying gaps, closing the gaps and documenting closure while aligning to that consumer’s unique care plan. VBC programs have inconsistent program rules, erratic delivery requirements and insights coming too slow to have meaningful patient engagement. The administrative energy required is a huge challenge.
HealthPointe’s Value Based Care analytic can help you meet these challenges by delivering consistent gap closure documentation that easily aligns to each payor’s standards and embedding gap information into your existing workflow without disrupting the provider’s experience.
Value Based Care Analytic Process
1. Identify Consumer Current Health
- Harvest the medical record for consumer population
- Create consumer risk registries through identification of Hierarchical Condition Categories (HCCs)
2. Identify and List Current Quality Gaps
- Align HCCs to quality care treatment program
- Evaluate consumer history to identify and organize list of gaps that need to be closed
3. Create Evidence of Risk Assignment and Gap Closure
- Ensure documentation includes “strength of evidence”
- Package gap closure documentation for unique delivery requirements
4. Continuously Monitoring
With each medical service performed, identify and alert program team of opportunities to improve compliance
