Amidst budget constraints, changing federal and state policies, and the challenges of meeting the unique needs of the Medicaid population, government agencies continue to make the shift to value-based care.
In this environment, it’s essential to have an accurate picture of current operations as well as insights into the future—issues on the horizon that can be prevented or mitigated. When agencies have 360-degree views of their populations and of each beneficiary, they are empowered to share data with other entities tasked with providing care—including pharmacy, behavioral health and other providers of care for specialty populations.
HealthEC helps government healthcare agencies optimize the health and well-being of their beneficiaries by providing a unified population health platform along with assistance needed to:
- Reduce clinical and administrative costs
- Identify gaps in care
- Address the social determinants of health
- Assess and improve provider performance
- Enable effective care coordination across entities that work together to address the needs of Medicaid beneficiaries
HealthEC’s population health management platform includes several CMS certifications and approvals, so government agencies can have confidence in addressing evidence-based measurements and outcomes for quality performance of all providers.
Evidence-based Measurement and Outcomes for Quality Performance of all providers, including:
MCOs, ACOs, FQHCs, Health Homes, Group Practices, Hospitals, Nursing Homes, and Individual Providers
QCDR (Qualified Clinical Data Registry)
Value-based Purchasing, Management and Administration Platform
Patient Engagement Model with George Washington University
Seven Conditions and Standards
CMS 2392-F Enhanced Funding and Modularity Standards
CMS 2390-F Quality Performance and Outcomes
Five Key Components for Enhanced Funding for Quality Analytics Solutions
State Medicaid Agencies
For State Medicaid agencies, HealthEC provides the ability to aggregate data from disparate organizations (Medicaid Managed Care organizations, Federally Qualified Health Centers, pharmacists and other provider types), risk stratify beneficiary populations, and develop tailored care plans that address the specific needs of Medicaid beneficiaries—while reducing unnecessary costs and closing gaps in care. Supporting a holistic view of the beneficiary, HealthEC supports complex care requirements by integrating medical and behavioral health data and factors in Social Determinants of Health, so that state Medicaid agencies and other healthcare organizations can easily coordinate care plans and connect beneficiaries to the services they need.
How can we help your state address its unique Medicaid challenges?
State and County Health Departments
On the front lines of healthcare delivery, state and county health departments needs tools that help their staff deliver quality care and ensure that limited resources are deployed most effectively. HealthEC equips state and county health departments with a population health platform that makes care assessments quick and easy. HealthEC's CareConnect module let’s care managers develop evidence-based, individualized care plans that integrate behavioral and medical health data, comorbidities, risk factors, and social determinants of health. Armed with reliable, 360-degree data on their beneficiaries, care givers can address gaps in care, coordinate complex care, and connect beneficiaries with the services they need to improve their health, all while driving costs down.
Prince Georges County, Maryland, leveraged HealthEC's analytics to improve population health