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Patient Centered Medical Home (PCMH)

The Patient Centered Medical Home Management solution enables health plans to reduce care program administration and management costs. It supports the increased promotion of wellness and high quality care, while streamlining collaboration between members, providers and health plans. Supported automation includes network design, collaborative workflow design, clinical integration, clinical tools and performance analytics.

Business Challenges:

• Facilitating increased collaboration and coordination for stakeholders
• Complexity of provider and member attribution for inclusion in care programs
• Scaling PCMH and ACO pilots to involve larger populations and geography
• Improving accuracy, timeliness and transparency of performance reporting
• Increasing clinical data information sharing between stakeholders
• Engaging members and providers for increased program adherence

Key Features:

• Automated care program design and inclusion for rapid program creation
• Drag-and-drop configuration of collaboration workflows
• Non-disruptive integration with existing provider office, lab and hospitals
• Web-based automation for provider & member collaboration, including secure document exchange, reminders and care alerts
• Drill-down dashboards and scorecards for performance & quality analysis
• Provider and member incentive management
• Flexible, modular solution approach for phased implementation

Key Benefits:

• Increased network and care program performance
• Increased collaboration and coordination with provider and members
• Increased transparency for performance management
• Flexible and nimble support of care program ramp-up
• Improved clinical data information for a complete care view of providers and members