To succeed in today’s market, payers need smart data, not big data.
HealthEC puts the power of smart data in the hands of payers so that they can collaborate with contracted providers to deliver quality, affordable care, improve quality measure performance, maximize value-based incentives, and attract and retain members.
HealthEC’s population health platform unifies and streamlines the management of complex healthcare data, providing payers with the information they need to address issues, such as unnecessary cost drivers and quality gaps. Equipped with cutting-edge technology, real-time data, and access to HealthEC’s KLAS rated advisory services, payers can also compare performance across providers and assess the effectiveness of plan designs and pricing strategies. Payers gain valuable insights into their business and can easily:
- Develop risk and performance management strategies based on clinical, financial, and quality data as well as population demographics
- Identify members for targeted care plans based on established clinical guidelines - and engage providers and members in those programs
- Evaluate plan and provider performance across clinical, financial, and operational metrics
- Detect waste, fraud, and abuse
- Generate reports for quality improvement initiatives and data submission requirements
To earn and maintain the Five-Star ratings that attract business and help fuel growth, Medicare Advantage (MA) plans must deliver the highest quality service to their members. This means improving not only the quality of care delivered, but also health outcomes and the member experience. Without visibility into member population data or a clear understanding of current risk and potential future risk among its members, MA plans lack the insight needed to manage effectively. HealthEC empowers MA plans with comprehensive data that allows them to risk-stratify members and coordinate with contracted providers on tailored care plans that engage and support members. It also allows plans to forecast likely costs of care, which helps to inform plan designs that meet members’ evolving needs, such as medication adherence support, chronic disease management, wellness programs, and concierge services. HealthEC helps MA plans keep unnecessary costs in check so they can provide sustainable value and tailored services to their members.
- Care plans with short/long-term care management goals, specific actionable objectives, and measurable quality outcomes, which include input from caregivers and primary care providers
- Data that equips leaders to remove barriers to care, redefine care coordination, better manage ambulatory care access, evolve urgent/emergent care models, and mitigate the impact of social determinants of health
Ready to see for yourself how HealthEC can support value-based goals?
Medicaid Managed Care Organizations
As changes to healthcare policy continue to impact the Medicaid market, it’s more important than ever that Medicaid Managed Care Organizations (MCOs) have access to reliable population health data. HealthEC provides MCOs with comprehensive beneficiary data and flexible, leading-edge technology needed to meet evolving federal and state requirements while supporting the health and wellbeing of the nation’s most vulnerable populations. Armed with HealthEC’s population health management platform, MCOs can easily risk-stratify their members and develop effective startegies to mitigate that risk. HealthEC helps MCOs and Medicaid providers tailor and coordinate care with 360-degree views of their beneficiaries’ needs, including those related to social determinants of health. Working together, MCOs and providers can engage and educate beneficiaries and connect them to the behavioral, clinical, and other support services needed while meeting value-based care goals of improving quality, accessibility, and outcomes in the most cost-effective manner.
Having a healthy workforce means your business can run at peak efficiency. Comprehensive and competitive healthcare benefits let you attract and retain the best talent on the market. But with the rising cost of care, how do employers offer attractive benefits while ensuring that healthcare costs are manageable? HealthEC give employers and third-party administrators insight into employee healthcare expenses and the tools to manage those costs. Empowered with data, unified on a single, easy-to-use population health platform, employers can risk-stratify their employee pool and prioritize high-cost segments for tailored healthcare interventions. When engaged through interventions targeted at high-cost conditions and supported by a proactive program of preventive care, employees tend to stay healthier and experience fewer high-cost incidents, such as ED visits and hospital stays. This translates into greater satisfaction for them and lower overall costs for your business.
See how you can ensure a healthy workforce while keeping your costs competitive.
What Our Clients Are Saying
Our reason for bringing on the HealthEC product is to truly integrate data from multiple sources and create a comprehensive view of the drivers of quality and cost. As we try to understand the total cost of care, we need data so that we understand which services were sought for outside of our hospital, and getting the data in a format that we can understand is key to understanding our total cost of care. We had large chunks of data that were missing from our clinical record, and by bringing together the claims data with data from the state health exchange, we have the full picture. HealthEC's strengths are identifying variability that drives cost and identifying the sources of that variability down to the drug, physician, site, or diagnosis. The HealthEC system allows me to identify where we need to make changes.VP/Executive – December 2021
HealthEC gives us a medical chart on steroids. It saves our records and saves the patient medical documentation in the cloud, and we can also schedule transportation from the system. We can use it to connect to our transportation department when people have outside appointments and they need to request transportation. We have a link that sends a daily copy of the medication administration record and certain charts. It does more than people would think it does. I wish that we had had a system like this years ago back when we had little black appointment books. I would have loved that. Now everything is in a system, and a patient's records are truly private.Analyst/Coordinator – November 2021
The system is amazing. We had a couple of providers who were still doing everything on paper, and when it came to doing GPRO and MIPS, rather than sending an inexperienced chart chaser, I went in with information preloaded on my laptop. The vendor preloaded their technology front end, and that was superb because it taught me how to do things. All of my questions were in the system, and all of the measures existed in drop-down menus. Our system populated the dashboard at HealthEC's main office in real-time, so even before I left the facility, I could quickly call HealthEC and ask whether I was done. Then HealthEC would look at the portal and tell me whether I missed something. It was really tremendous because everything was done in real time. I am not a high-tech person, so if someone like me can figure out the system, then anybody can figure it out. When we have had discussions with HealthEC regarding things that we need to do or identify, they have done those things. I have found absolutely nothing that HealthEC is not capable of doing.VP/Other Executive – November 2021
I always recommend HealthEC to others. Almost every time someone asks who they could partner with to demonstrate how to use data to improve quality outcomes, HealthEC is my number one referral.CEO/President - October 2021
The product is part of our long-term plans because we have a continuing need for an application that allows us to look at utilization based on claims. HealthEC’s product is the only software I have seen that performs well in terms of showing us claims data. The product has a huge reporting capacity for utilization and claims data. We can tell that HealthEC knows claims data. They have several different ways to look at utilization that are important for the work that we are trying to do. We continually need data to help us understand the populations and the variations we are dealing with. The MCOs in the Medicaid space have shifted and continue to shift. We are looking at contracting with MCOs, and we have accumulated data over the years, so we have a robust history. If patients move from one MCO to another, the MCO has some limited information about the beneficiary, but we have all the information because we have seen the patients go from different MCOs while staying with the same provider. Patients’ insurance providers may change, so having data has been helpful.CTO - October 2021
As we progressed with our shared savings program and got closer and closer to success, we realized that we needed an analytics tool that could help us improve. We were introduced to HealthEC by a respected peer, and we figured that HealthEC would be a safe bet for what we needed. We looked at their product and found that it was definitely robust. HealthEC has a background with strong analytics for shared savings. We needed a platform that could take our data and show us the patients that we needed to spend more time with so that we could be more efficient in how we spent our time. We really liked HealthEC's platform, and the vendor explained to us how we would use it. Its price point was very attractive, and it offered us what we needed. The person that we talked to from HealthEC was very knowledgeable, kind, and available.CMIO - September 2021
HealthEC's solution is a nimble, easy-to-use system with good reporting functionally. The system is quick to ingest third-party data.VP/Other Executive - September 2021