Medecision, a population health management company for risk-bearing healthcare organizations has unveiled Aerial™ for Medicaid and Medicare Advantage, a suite of modular clinical and financial apps focused on improving CMS Medicare and Medicaid population health.
These essential tools deliver better patient outcomes, reduce care cost, and enable critical complex care management strategies by:
– capturing quality measures;
– assessing baseline data; and
– efficiently complying with changing regulations over time.
As health plans expand coverage of government beneficiaries, their priorities shift to improving care, managing to quality measures, and ensuring risk score accuracy all within a dynamic regulatory environment. Public measures of quality also grow in significance, with consumers focusing on STAR quality ratings that drive significant revenue advantage to the plan.
Progressive plans can now reap the benefits of these tools through a secure Aerial cloud deployment, reducing the investment and support requirements associated with legacy care management implementations, and improving time to value with out-of-the-box functionality, application and web service integration.
The platform and apps in this population health management suite today include the following:
- – Aerial Insights: big data platform to identify and engage high-risk members; make meaningful strides in quality and cost; and automatically generate government and payer-specific compliance reports such as STARS, GPRO/ACO, P4P, and HEDIS.
- Business logic supports real-time assessment data, along with labs, CAHPS surveys and claims, to more effectively enable health plans to measure HEDIS under the five clinical domains and, importantly, monitor bonus payments for any reimbursement program.
- Advanced data analytics, and preconfigured and custom reporting capabilities generate a transparent view across population cohorts; individual patient risk factors that may require individualized care plans; and quality, clinical and financial performance across populations and provider networks.
- – Aerial Complex Care Management: patient-centered, comprehensive care planning feature which meets CMS’ requirement for a care plan shared by the entire interdisciplinary team.
- The care plan is auto-populated with data, clinical content and recommendations personalized to member/patient needs and highlights priority health concerns. This insight improves care team and intervention efficiency, as well as shared interdisciplinary team decision making and coordination.
- Aerial Complex Care Management also supports dynamic regulatory requirements like tracking of complaints, appeals and grievances, and care coordination of dual-eligibles.
- – Aerial Risk Revenue Maximization: automatically calculates and updates risk score models such as Hierarchical Condition Coding (HCC), based on the member/patient’s latest clinical situation according to specs provided by CMS.
