PHOENIX, Jan. 8, 2020 /PRNewswire/ -- HealthBI®, the technology division of Equality Health, announced today that its CareEmpower® platform experienced another year of record growth, doubling revenue in 2019. Its broad market reach—available to over 70,000 provider practices—expanded even further this year with a 50 percent increase in members covered. The platform now enables the delivery of proactive, preventive care for nearly 20 million members in Medicaid managed plans, Medicare Advantage, and commercial health plans.
HealthBI president Doug Duskin gave the following commentary on factors driving CareEmpower's year-over-year growth. Executives from Equality Health will also be available to discuss the tech division's growth at the upcoming 38th Annual J.P. Morgan Healthcare Conference. For inquiries about a meeting at the conference, contact [email protected].
The Mainstreaming of Medicaid Managed Care
One of the most significant developments in public health policy in the past decade is the shift to risk-based, Medicaid managed care. Today, the vast majority of Medicaid beneficiaries receive care under this model, which in turn is the de facto model for Medicaid in a majority of states.1 It comes with a challenging caveat: Medicaid managed health plans and providers must be able to demonstrate they are meeting stringent benchmarks for quality, member outcomes, and cost.
"Medicaid agencies are increasingly determined to move the needle on health outcomes for Medicaid beneficiaries, who are among the country's most complex member populations. This puts significant pressure on managed care plans--and the providers in their networks--to work more efficiently and collaboratively to improve member outcomes," noted Duskin.
He added, "Most importantly, health plans and their provider partners need shared technology to coordinate care for the members they serve. CareEmpower was designed to close the information gap between plans and providers to improve outcomes for members across a broad spectrum of acuity."
In a notable example, this year Banner-University Health Plans chose HealthBI as its technology partner to integrate behavioral and physical healthcare, basing its new Care Navigation Accelerator on the CareEmpower platform. Now provider practices across the Banner–University Health Plans network see an integrated view of members' physical and mental health history, medication history, and even social determinants of health, right at the point of care.
Providers can then act on the member's needs within minutes, from prescribing the right medication to referring members to appropriate services. This includes referrals to substance abuse services, with appropriate member consent in place, in minutes or less.
All told, CareEmpower is now deployed to manage care coordination for 8 million Medicaid managed care members throughout the country. That's an increase of 50 percent over the previous year.
Medicare Advantage Plans Remain Popular
America's Medicare beneficiaries continue to utilize commercial "Medicare Advantage" plans in increasing numbers, with enrollment in such plans nearly doubling over the past decade.2 Here again, Medicare Advantage plans and providers are required to provide evidence that members receive quality care that emphasizes wellness, prevention and proactive management of chronic conditions.
In turn, these providers need an accurate understanding of member acuity to assure the necessary resources to care for these members. CareEmpower offers health plans and providers a shared platform from which to risk stratify members and identify their gaps in care with a newfound clarity. Over the past year, CareEmpower nearly doubled its Medicare Advantage coverage and now supports more than 8.5 million members.
Built for Risk-Based Care
As both of the above trends indicate, health plans and providers are increasingly expected to deliver better outcomes at a lower cost. Neither can bear the cost savings alone, but providers are taking on an ever greater share. Accordingly, CareEmpower is designed to help providers successfully care for complex populations—and receive proper and accurate reimbursement. The platform offers:
- Proactive workflows for prevention, quality management, and transitions of care
- Tailored care coordination protocols for high-risk members
- Integrated views of physical, behavioral, and sociocultural risk factors
- Member engagement at scale
Nationally, HealthBI's care coordination platform is the provider enablement technology offered by the nation's four largest health plans. In Arizona alone, CareEmpower coordinates care for over 1 million lives, serving as the care coordination platform for five of the seven AHCCCS Medicaid plans. It provides crucial support to help providers prove and meet their risk-based contracts under the AHCCCS model of care that emphasizes integration of physical and mental healthcare with community resources.
"Given its market reach, CareEmpower is playing a central role in the creation of a national blueprint for whole-person healthcare," Duskin concluded.
HealthBI was founded to unify fragmented healthcare systems and help care teams succeed in an increasingly outcomes-driven world. Since 2012, HealthBI's care coordination technology has been deployed by the country's largest payers to support practices and the community in improving the continuity of care and optimizing value-based performance across more than 20 million Medicaid, Medicare and Commercial lives, including some of the most complex populations in the nation.
HealthBI is a division of Equality Health, the Phoenix-based whole-health delivery system that deploys HealthBI's flagship CareEmpower solution to enable culturally competent, value-based care for underserved populations. Learn more at www.healthbi.com and follow HealthBI on Twitter and LinkedIn.
For HealthBI, contact:
Stephanie Janard at [email protected]