White Paper February 21, 2017

Enabling Payer and Provider Collaboration in the Journey Toward Quality Care

This white paper describes this new healthcare economy and outlines ways in which payers and providers can work together to achieve their quality goals. We’ll discuss the role of data-driven, scalable quality management analytics in closing gaps in care, avoiding duplicative care, achieving high quality scores, and improving patient care. We’ll show how the technology enables payers and providers to collaborate toward a holistic, data-driven approach to population-based quality care—ultimately to aid in the journey to value-based care.

Download White Paper

There was a problem submitting your request.
Please ensure you filled in all required fields.

Complementary Solutions

  • Employer Reporting

    Employer Reporting provides collaborative, modern health care analysis and reporting that increases employer retention, reduces strain on internal reporting staff, and improves client satisfaction. Employer Reporting integrates with MedeAnalytics’ full enterprise suite.

  • Healthcare Economics

    Crucial to the success of any health plan is analyzing healthcare economics and understanding high-cost members to steer them toward quality, timely care. Healthcare Economics pinpoints patterns and correlations that reveal opportunities for savings. It enables you to take strategic action, mitigate catastrophic claims, promote better health, and gain insight into costs, quality drivers, and at-risk populations.

  • Medicaid Management

    Medicaid plans face unique challenges serving beneficiaries. The only Medicaid-specific solution on the market, Medicaid Management helps Medicaid plans to address the needs of vulnerable populations, improve care for high-volume, multi-comorbid, chronically ill beneficiaries, and extend those lessons to the Exchange market.

  • Performance Management

    Performance Management combines robust analytics with action planning, resource assignment, progress tracking and performance monitoring—all in one closed-loop performance improvement system—to ensure the organization is on the same page at the same time, working toward the right goals and achieving the best possible results.

  • Pharmacy Management

    Pharmacy Management provides health plans with deep insights into pharmacy utilization and spend, uncovering opportunities to reduce costs and risk. With integrated medical and pharmacy data, you can address incidences of polypharmacy, identify therapeutic alternatives, improve contract performance evaluation, and mitigate the risk of fraud, waste, and abuse. The insights enable a pharmacoeconomic approach for determining drug therapies based on their comparative value.

  • Population Health

    Population Health reveals the clinical opportunities that lead to healthier populations. Integrating claims, clinical and provider data, it enables health plans and providers to collaboratively deliver on the promise of risk- and value-based contracts.

  • Provider Analytics

    In today’s healthcare environment, building high-value provider networks is vital. Provider Analytics gives you insight into the cost and performance of your providers so you can address value and usage, centers of excellence opportunities, and provider practice patterns. When integrated with other MedeAnalytics solutions, it gives you a single source of truth to improve strategic decision-making across the enterprise.

  • Quality Management

    As the industry increasingly focuses on quality of care, it’s important for health plans and other payers to implement quality management programs that monitor and support quality care measures. MedeAnalytics Quality Management offers insights that enable health plans to understand performance on quality measures, monitor pay-for-performance, achieve VBP4P and HEDIS® compliance, and ultimately improve quality care for their members. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)