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Advisory Services

Transformation Consulting

HealthEC® provides a wide range of consultative services to manage the Quality and Costs of target chronic care populations.

 

Provider Enrollment & Registering with CMS

  • HealthEC manages the entire process from enrollment and registration to education and training
  • Register the Organization and Providers with CMS for ACO and Private Payers
  • Guidance on successful governance/infrastructure models
  • Assist with setting up the ACO structure, board and committees
  • Define financial and quality metrics to meet and exceed CMS and payer objectives

Provider Clinical Transformation, Education and Outreach

  • Practice Education and Consulting for ACO Measures
    • Develop goals/objectives with the practice to improve quality
  • PCMH Lite Workflow (Element 1, 2, 2a, 4a)
  • Provider Communication & Education
  • Beneficiary Communication & Education
  • Provider Training

Financial/Governance Consulting

  • Provider Payment Models
  • Population Risk Management
  • Thorough data analysis to provide clear, actionable steps to obtain cost reduction and quality improvement
  • Financial Risk Assessments
  • Clinical Protocol for Care and Physician Consulting

Audit and Reporting

  • Chart Chasing for GPRO Reporting
  • Commercial Payor Audit
  • Advice on which Quality Measures to sign-up for

Care Coordination

  • Create Care Management Models in line with client’s needs which can include any of the following team members or a combination thereof:
    • Case Management Nurse
    • Transitions of Care Nurse
    • Disease Management Educator
    • Wellness Coach

Clinical Care Management Services

  • Utilize clinical and population health management expertise to strategize on the implementation of an effective and efficient Population Health Management program. Assist with medical decision making with respect to Tier One Risk patients.
  • Recommend opportunities and initiatives to the ACO management team that would facilitate the reduction of cost and improve quality. Develop policies and procedures with respect to clinical care in the ACO.
  • Implement practice transformation initiatives to improve throughput, eliminate redundancy, and engage employees and staff.
    • Physician Engagement – present providers with a roadmap for practice transformation
  • Serve as liaison to the ACO Medical Directors.