Government Program Management for Healthcare
Ever-changing regulations in already complex government programs require deep expertise. From Medicare to Medicaid to exchange plans, we provide decades of experience with comprehensive medical and pharmacy technology, analytics and service solutions.
MA Strategies: Your Guide for Early and Ongoing Assessment
Medicare Advantage roadmap for annual member engagement/interval measurement, and strategies for leveraging demographic and other available data sources.
Create a Proactive Plan to Assess Individual Health Needs
Humana Health Informatics uses the Johns Hopkins ACG® System for segmentation of their Medicaid population. See their results in this success guide.
Analyze enrich and abstract relevant information for HEDIS rate determination; ensure data accuracy, facilitate compliance and streamline HEDIS reporting.
Support Where You Need It Most
Core Administration Processing Technology and Services Government compliant software and operations with medical, prescription and enrollment platforms to administer coverage on all lines of business. Scalable and flexible technology so you can start a new line of business or outsource functions as needed.
Total Cost of Care Management Population stratification, formulary optimization and specialty services are some of the solutions we offer that empower you to better understand and monitor the total cost of care for your members.
Risk & Compliance Support of your oversight and monitoring activities with proactive software updates to meet government mandates along with deep knowledge of business requirements, not just technology needs.
Member and Provider Engagement Solutions to help you improve ease and delivery of care for your members and support your value-based provider arrangements.
Revenue and Quality Optimization Analytics-driven and service solutions using industry-accepted standards to meet all required measuring and reporting, along with tools to monitor and optimize your revenue and quality.