Finding Value & Revenue in Assessments

Assessments alone mean little unless they are in a platform like ours, that identifies further medical necessities and creates care plans for needed assessments, diagnostics, ancillaries, etc.  It is this total program that drives superb value based metrics, revenue and overall savings.

Everyone thinks population health assessments are so easy. They are not. Yes, some of the most popular of the 32 mandated and incentivized assessments are resident in every EHR but rarely done?  Why? The provider has no idea who has medical necessity for what, and the assessment would have to be performed in real time in the clinic using already overburdened staff with little or no experience in this field.

The EHR is a forensic tool and can only tell what has been done, not the hundreds of things missed, nor does it have our ability to determine individual medical necessities for each patient, and then provide a hyperlink for the assessments to be completed in the comfort of their own homes. Within the results of our assessments, driven by medical necessity, are the appropriate care plans.

We even have a national network of 6,000+ PAs and NPs to complete these tasks on behalf of the provider in the background away from the workflow of the practice. In Medicare fee of service this sharing of results and care plan with the patient makes the event billable.

We also have over 700 medical algorithms and calculators by specialty. These are invaluable in getting the total patient picture. In a Medicare Advantage, ACO, other capitated or cost restrained programs, our nominal per member per month will provide superior value based metrics without billing the system for the standard CPT rates.

We’re seeing a real trend by these types of organizations going directly to the patients rather than waiting for the provider to get these tasks done via the provider. They find it much faster and much cheaper to let our technology do the job for them.