SCOTTSDALE, Ariz., Dec. 14, 2017 /PRNewswire/ -- Healthcare insurers finally cracked the code this year on how to gain real time insights into member health, thanks to a technology platform from population health management company HealthBI. This portends nothing less than the practice of true preventative health, long a holy grail for bending the healthcare cost curve, but impossible to achieve by analyzing months-old claims data. As such, payers snatched up the platform to give to the providers under their network—advancing the platform into 62,000 clinical sites and securing a 95 percent provider adoption rate.
That's an increase of 57,000 sites. It also makes the HealthBI platform the most widely used, payer-driven care management and coordination system for population health management today. The platform is now deployed across 50 states.
"What we're really creating is the 'future state' for payers and providers to work under risk contracts—to work together to cut waste and overutilization from our national health bill and steer entire populations toward healthier outcomes," observed Scott McFarland, president, HealthBI.
The company's flagship care management and coordination platform is provided to physicians and clinicians by healthcare payers, and connects all care teams in a single virtual setting. From this same platform, care team members can view the patient's current healthcare activity and collaborate together on care plans.
Much of this effort can qualify providers for financial incentives under their risk-based contracts. To that end, HealthBI also focuses on making it simple for providers to certify for these incentives.
In one significant example, the company launched a "Continuity of Care Document" or "CCD" engine this year that extracts related data from a provider's EMR/EHR into the HealthBI platform. The company also founded a Contact Center to further support providers in documenting their quality efforts—a program that has proven so successful, HealthBI will be doubling it by mid-2018.
McFarland added that all of these milestones have essentially moved the company to a distinctly different stage.
"Given the huge leap in clinical sites, our year-over-year revenue growth, and the fact that our customer family now includes two of the top three health plans in the nation, HealthBI is clearly no longer a start-up. We're a successful early stage company that is shaping a dynamic and growing model of healthcare," McFarland said.
Trendspotting for 2018: Payers expanding risk contracts, integrated care takes off
The writing is on the wall: our healthcare bill—and the health of Americans--has reached levels that can no longer sustain the old fee-for-service model. To that end, value-based reimbursement no longer hinges on government healthcare policy, even if it was ushered in by the Affordable Care Act.
"Payers will continue to expand risk contracts in 2017 that reward providers for improving health outcomes; an objective far easier to meet with technology that enables a current view of patient health," weighed in Koorosh Yasami, founder and chief strategy officer of HealthBI, and himself a former executive with healthcare payer giant UnitedHealth Group.
As an example of a problem HealthBI is solving, Yasamai noted the expensive overutilization of the emergency department.
"If I know a patient is out of the hospital within 24 hours, I can bring that patient in for follow up care that prevents a costly readmission. But if I don't have that timely insight, if I'm relying instead on sifting through 90 days of claims data—by that point, the patient has returned to the hospital two or three times," he explained.
HealthBI has built its entire technology strategy around overcoming these barriers, drawing on its dual payer industry and data integration expertise to create a single and collaborative setting for proactive care management.
The company's care management and coordination platform also facilitates another growing trend—the integration of physical and behavioral healthcare. HealthBI customers like Community Partners and Partners in Recovery use the platform to significantly reduce overutilization of ED and acute care services by members with behavioral health issues—and replace with more appropriate primary care services.
McFarland concluded by underscoring the importance of creating risk contracts that are achievable for more providers to meet in the coming year.
"One thing for certain is that more of the risk is going to be pushed down to providers. With this in mind, payers will be expected to give the providers in their network reliable, simple tools to take this risk on. This trend will only grow stronger in 2018 and will certainly shape product development here at HealthBI," McFarland said.
Headquartered in Scottsdale, Arizona, HealthBI was created by a team of industry leaders and physicians to fill the need for tools that enable health care payers and providers to reduce admissions and readmissions, automate care transition and improved value-based care performance and HEDIS outcomes. Today, the company's care management and care coordination platform for population health management is the most widely deployed in the nation—used in over 60,000 clinical sites across 50 states. HealthBI customers have reported results that span from a 25 percent decrease in 30 day re-admits to a nearly 300 percent improvement in closing gaps in patient care. To learn more about HealthBI, visit healthbi.com and follow HealthBI on Twitter and LinkedIn.
Amendola Communications for HealthBI