Archive for September, 2013
HighRoads, an industry leader in benefits plan management and health care compliance, today launched the HighRoads Medicare Advantage Governance Solution specifically designed for Medicare Advantage payers. The centralized, software-as-a-service solution based on The Source by HighRoads produces a comprehensive system of record for all benefits plan data which simplifies and speeds the production of compliant Medicare Advantage participant documents and Centers for Medicare & Medicaid Services (CMS) submissions.
“Tight deadlines to meet annual CMS bid process material submissions along with increasingly stringent requirements to produce and deliver accurate compliance documents for plan participants have put increasing strain on Medicare Advantage payers,” said Lori Dustin, chief marketing officer, HighRoads. “Now, Medicare Advantage providers can eliminate the costly risk of human error with a centralized system of record for all of their benefits plan data, assuring the reliable and compliant delivery of all required materials.”
Based on HighRoads’ proven benefits plan management system, The Source®, the HighRoads Medicare Advantage Governance Solution uses a patented benefits Extract Transform and Load (ETL) technology to create normalized plan designs that include both the plan benefit package data required to be submitted to CMS as well as the additional variable data needed to produce Medicare Advantage materials including Annual Notice of Changes (ANOC), Evidence of Coverage (EOC) and Summary of Benefits (SB) documents. Through consistent benefits plan data the HighRoads Medicare Advantage Governance Solution also helps payers reliably produce CMS Bid Pricing Tool (BPT) materials for more accurate and timely submissions.
Featuring built in business process workflow, the HighRoads Medicare Advantage Governance Solution ensures that all benefits plan data is accurate and approved by marketing, compliance and other required subject matter experts – with compliant log files and chain of approval tracking records.
“For years Medicare Advantage Payers have struggled with the timely and accurate production of compliant documents and CMS materials, relying almost entirely on costly and error prone manual processes,” said Edward J. Novinski, former UnitedHealth Group (UHG) executive responsible for UHG’s Commercial Medicare and Medicaid networks and HighRoads board of director. “Now, HighRoads is enabling Medicare payers to have a central record of truth for all Medicare Advantage plan data which improves the efficiency and accuracy of
every required plan document eliminating the cost and risk of human error.”
HighRoads’ SaaS-based Medicare Advantage Governance Solution:
HighRoads Launches Medicare Advantage Governance Solution for Health Insurance Payers
HighRoads, an industry leader in benefits plan management and health care compliance, today launched the HighRoads Medicare Advantage Governance Solution specifically designed for Medicare Advantage payers. The centralized, software-as-a-service solution based on The Source by HighRoads produces a comprehensive system of record for all benefits plan data which simplifies and speeds the production of compliant Medicare […] »
Mission-Driven Company Poised for Continued Growth
“I joined APS because of its mission, exciting and disruptive platform, and rapidly growing customer base,” said Russ. “The opportunity to strengthen and support the performance of physicians and nurses – the dedicated professionals who deliver care every day – combined with the chance to lead an organization experiencing such rapid growth, made the decision to join APS incredibly easy.”
“Russ Richmond brings to Advanced Practice Strategies a wealth of leadership experience and expertise,” said APS board member Jeff Stolte, Investment Manager at Ascension Health Ventures. “After nearly 20 years in business, with services deployed in more than 25% of U.S. hospitals, APS has launched a new disruptive technology and achieved significant growth. Russ’ demonstrated expertise in setting and executing strategic direction, combined with his mission-driven style, was an excellent match for the company’s needs. His energy and vision are evident and will be an asset to the company and its clients.” Ascension Health Ventures is an investor in APS.
Russ began his career at McKinsey & Company after completing his medical training. Subsequently, he took the role of Executive Vice President for D2Hawkeye, a company that primarily served the healthcare payer market and was acquired by Verisk Health in 2009. He returned to McKinsey in 2009 to launch Objective Health, a data analytics solution focused on healthcare providers. Russ also currently serves as a board member of Explorys, a data and analytics platform for healthcare transformation.
Russ earned his Bachelor of Science degree from the University of Michigan, his medical degree from the University of Cincinnati, and completed his internship in Internal Medicine and Pediatrics at the University of Michigan. He resides with his wife and three children in Newton, Massachusetts.
About Advanced Practice Strategies:Advanced Practice Strategies (APS) is eliminating risk and reducing healthcare costs by fundamentally restructuring lifelong clinical education. Using a data-driven approach, APS is objectively assessing clinician knowledge and judgment, quantifying resulting risk, and reducing that risk through personalized education. The company’s newest innovation, GNOSIS, is a groundbreaking mobile, cloud-based tool that saves clinician learning time, rapidly improves performance, reduces medical malpractice risk, and increases patient safety, all while ensuring administrators are equipped with a transparent performance dashboard at the clinician, organization, and system-wide levels. GNOSIS redefines continuing clinical education while addressing healthcare quality, costs, and satisfaction in today’s accountable medical world. Grounded in the rich experience of its Demonstrative Evidence Group, that uses visual strategy to educate juries in complex medical malpractice cases, APS has amassed a wealth of knowledge on risk in medicine and has become the leader in improving lifelong clinician learning. For more information, please visit APS.
About Ascension Health VenturesAscension Health Ventures (AHV) was launched in 2001 as a wholly-owned subsidiary of what is now known as Ascension Health. Today it is a subsidiary of Ascension, a parent holding company formed in 2012. AHV’s role has been to construct and manage a strategic portfolio of investments that deliver a venture investment return, have the potential to transform the healthcare industry, and significantly enhance the experience for patients, their families and their caregivers. AHV has three venture funds under management and its limited partners include Ascension, Catholic Health East, Catholic Health Initiatives, Decatur Memorial Hospital, Dignity Health, Intermountain Healthcare and Mercy. To learn more, visit Ascension Health Ventures.
Advanced Practice Strategies Announces New Chief Executive Officer
Mission-Driven Company Poised for Continued Growth Boston, MA – Advanced Practice Strategies (APS) today announced Russell Richmond, MD as its new Chief Executive Officer and Board Director. Russ joins the company from Objective Health, a division of McKinsey & Company. APS accelerates high reliability in healthcare delivery by measuring and improving clinical knowledge and judgment. The […] »
Curaspan and Phytel Partner to Enhance Care Coordination, Reduce Avoidable Hospital Readmissions and Improve Patient Satisfaction
Newton, Mass. — Curaspan Health Group®, the industry leader in patient-transition solutions for hospitals, post-acute care providers and payers today introduced OutreachCentral, the latest addition to its suite of software-as-a-service solutions. OutreachCentral helps identify patients most at-risk for readmission by automating post-care phone calls to patients discharged home from inpatient care and emergency departments. Integrated with the Curaspan core offerings, OutreachCentral helps optimize quality of care and patient satisfaction.
OutreachCentral integrates with DischargeCentral®, the Curaspan cornerstone product, which automates and tracks patient discharges to post-acute care facilities. The combined solution enables hospitals to manage 100 percent of their population with minimal administrative intervention and facilitates the daunting task of reaching every patient discharged within 72 hours. The automated phone call gauges patient understanding of discharge, medication and follow-up care plans and allows clinicians to triage patients with critical health issues.
“Together, OutreachCentral and DischargeCentral will provide hospitals with a broad range of insight,” says Curaspan President and CEO Thomas R. Ferry. “The solution gives our customers the tools they need to deliver measurable value with a patient-transition process that yields the highest clinical quality and patient satisfaction at the lowest cost.”
OutreachCentral is powered by Phytel, the premier company empowering physician-led population health improvement. The solution is designed to both reduce avoidable readmissions and improve HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) patient satisfaction scores. It leverages hospital and physician electronic health record data and clinical rule sets to identify recently discharged patients at high risk for readmission. It then delivers automated daily health and assessments over the phone to gather information and feedback from the patients. Hospitals can call back patients who have other concerns about the care they received, providing another opportunity to improve patient satisfaction scores, now publicly available on the Centers for Medicare and Medicaid Services’ HospitalCompare website.
”We are excited to partner with Curaspan, an industry leader in managing acute and post-acute care transitions, to provide a new level of transition management for their clients,” said Steve Schelhammer, CEO of Phytel.
Matt Waldron, Phytel Senior Vice President of Strategic Business Development, added, “In combination with Curaspan, Phytel can provide hospitals with automated outreach they need to avoid unnecessary readmissions and improve patient satisfaction while reducing costs.”
Phytel has been recognized nationally for helping health-care organizations drive patient-centered, high-quality care. Three of the company’s solutions have achieved pre-validation status from the National Committee for Quality Assurance (NCQA), giving physician clients autocredit toward patient-centered medical home status. Founded in 1999, Curaspan set the standard for the secure transmission of clinical data about patients moving from one level of care to another. Long-standing customers include Saint Thomas Health (part of Ascension Health), Vanguard Health Systems, Amedisys Home Health Care, American Medical Response, Gentiva Health Services, Golden Living and Life Care Centers of America.
About Curaspan Health Group
Curaspan Health Group connects providers, payers and suppliers via secure electronic patient-transition networks to improve outcomes as patients move between levels of care. Interoperable with all HIS, it’s the foundation for initiatives like ACOs, HIEs, value-based purchasing and other evolving models of care and reimbursement. With a unique combination of workflow tools, content and service, its Web-based platform helps improve operational efficiency and clinical care at leading health-care organizations nationwide. Founded in 1999, Curaspan headquarters are in Newton, Mass.
The premier company empowering physician-led population health improvement, Phytel provides physicians with proven technology to deliver timely, coordinated care to their patients. Phytel’s state-of-the-art registry, which now encompasses more than 30 million patients nationwide, uses evidence-based chronic and preventive care protocols to identify and notify patients due for service, while tracking compliance and measuring quality and financial results. Phytel is ISO 9001:2008 certified, confirming adherence to ISO’s internationally recognized Total Quality Management (TQM) standards. For more information, please visit www.phytel.com.
Curaspan Health Group Announces the Release of OutreachCentral to Automate Post-Discharge Communication for Patients at High Risk of Readmission
Curaspan and Phytel Partner to Enhance Care Coordination, Reduce Avoidable Hospital Readmissions and Improve Patient Satisfaction Newton, Mass. — Curaspan Health Group®, the industry leader in patient-transition solutions for hospitals, post-acute care providers and payers today introduced OutreachCentral, the latest addition to its suite of software-as-a-service solutions. OutreachCentral helps identify patients most at-risk for readmission by automating […] »