Collaboration between payers and providers through clinically integrated networks (CINs), accountable care organizations (ACOs) and physician-hospital organizations (PHOs) is essential for delivering value-based care. Yet many of these organizations lack the technology to meet pay-for-performance objectives. Population health data is often limited, and many providers struggle to equip physicians with information they need to help patients achieve desired outcomes. Without timely, useful performance data, payers have difficulty receiving reimbursements and delivering payouts to providers.
Our expertise in migrating, integrating and analyzing clinical data can help you collect the information and analytics you need to achieve objectives of pay-for-performance programs. Along with capturing and converting data into useable formats, we can help you develop a standard set of metrics or reports that can easily be configured for any payer or provider, regardless of their hardware and software technology stack. These plug-and-play reports highlight key performance indicators outlined in payer contracts and which providers are in compliance, along with issues preventing reimbursements, such as problems with data that may be driving up Medicaid denial rates.