PointRight® Launches Analytics Solutions For Healthcare Payers
The company extends its skilled nursing facility advocacy to payer organizations; hires key staff to support growth in healthcare payer market
CAMBRIDGE, Mass., June 3, 2015 /PRNewswire/ -- PointRight, the leading provider of analytics solutions that improve post-acute care, announces the launch of its new predictive analytics and performance measurement tools. The toolset is ideal for those focused on improving consumer experience and clinical outcomes, including hospitals, Managed Care Organizations (MCOs), Accountable Care Organizations (ACOs), CMS Bundled Payment contractors and specialty care organizations. The new PointRight toolset has been developed based on over 20 years of experience in partnering with Skilled Nursing Facilities (SNFs).
"As the healthcare industry moves its focus from volume to value, there is a tremendous need for providers and payers to align," said Steven Littlehale, Executive Vice President and Chief Clinical Officer of PointRight. "For the past 20 years, we have been the champion of SNF provider, leading the way with MDS (Minimum Data Set) data analytics to reduce unnecessary re-hospitalizations, efficiently improve quality of care and exceed compliance mandates. We are uniquely positioned to advocate for patients and skilled nursing facilities as health care reform brings an alignment between providers and payers. "
PointRight's analytics solutions enable payer organizations to improve the quality of post-acute networks, improve care transitions, track member's health status in real-time and ensure care plans address all of the members' risk factors. PointRight is increasing efficiency and decreasing the cost of care through four analytics-powered solutions:
- Building and managing a quality network of skilled nursing facilities focused on improved patient results: By using nationally recognized quality metrics, clients are now able to identify the providers with the superior record of achieving the best patient outcomes. We are able to provide diagnosis-specific re-hospitalizations and quality metrics based on empirical evidence. This transparency enables the forging of true partnerships. Now you can use the power of experience to set your skilled nursing facility network up for success.
- Understanding the member's needs, risks and impairment in real-time: Use existing post-acute data sets to accurately evaluate the needs of your members in a SNF. You can easily identify their impairment level for pain, mood, cognition and "Activities of Daily Living" (ADLs) and proactively manage complications such as falls, pressure ulcers and re-hospitalizations.
- Matching members' needs to the right provider: Assess a patient and match them to the SNF based on their individual needs and the provider's care capabilities. Not only do you improve the patient's outcome but you also help the SNF, giving them a patient for which they are best prepared and skilled.
- Identify Care Gaps and Improve Risk Adjustment: Understanding a member's situation is critical to helping them to live to their fullest. Little is better at doing this than using the existing clinical records. CMS established standard records for post-acute care years ago. They are called the MDS (minimum data set) and the OASIS (Outcomes and Assessment Information Set). Now you can use these records to add to your existing care-gap and risk identification processes. Doing so will enable you to improve patient care by more fully understanding all the risks that need to be addressed when establishing a care plan.
Responding to the evolving changes in healthcare and to ensure business growth, PointRight has added two key leaders, both of whom have extensive expertise in the industry. Kili Chivers, Executive Vice President, Payer Solutions, joins PointRight after 10 years in the managed care industry where she held leadership positions within several leading MCOs. Larry Diamond, Executive Vice President, Corporate Development, comes to PointRight with 20 years of experience at organizations including Insignia Health, American TeleCare, Alere, and United Healthcare.
"The industry wants to better understand SNF outcomes and learn how to best structure these crucial relationships within their networks. PointRight has extensive knowledge of SNFs and expertise in predictive analytics," said Kili Chivers, Executive Vice President, Payer Solutions. "Our role is to be the data intermediary to ensure everyone is using the same analytics and metrics to measure quality and care outcomes. For example, MCOs and ACOs are using the PointRight® Pro 30™ Rehospitalization metric as the standard. They also see value in other PointRight solutions, such as PointRight Pulse™ as a best-practice tool to understand patient individual risk and impairment needs. CMS Bundled Payment contractors are recommending these tools be used by the SNFs within their networks. Through analytics-driven solutions, we're pleased to bring measurability, consistency and value to improve quality of care for patients.
Larry Diamond, Executive Vice President, Corporate Development, says "PointRight can now help consumers answer the difficult question, 'Which provider is best to meet my unique needs?' By measuring recent outcomes and evaluating performance and then applying sophisticated mathematics we are able to help identify the providers that can best help the individual get better. When you match a person's clinical needs to a provider's proven ability, you'll dramatically improve outcomes. Given all of the changes in healthcare, adding a quality-focused, post-acute network is one of the easiest steps an organization can take to improve quality and reduce cost."
ABOUT POINTRIGHT
PointRight is the industry-standard analytics leader that enables healthcare providers and payers to measure risk, quality of care, rehospitalization, compliance and reimbursement accuracy. Using some of the largest and best databases in the industry, PointRight's nationally recognized clinical staff, researchers, and technologists expertly translate data from multiple sources into actionable information and insight. Visit www.pointright.com.
SOURCE PointRight
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