|By PR Newswire||
|February 11, 2014 08:30 AM EST||
BOSTON, Feb. 11, 2014 /PRNewswire/ -- MedAptus® today announced that it has released a Risk Severity Toolkit to help provider groups measure and manage the disease burden of patients covered under risk-based contracts. The initial version focuses on the Medicare Advantage (MA) patient population where premiums paid to MA health plans are based on enrollees' severity history using the Centers for Medicare and Medicaid Services (CMS) Hierarchical Condition Categories (HCC) model. Providers are increasingly at risk under contracts with MA plans, both financially and administratively, to properly document and manage patients' clinical risk.
In 2004, CMS upgraded its method to adjust capitated payments to MA plans using the HCC model, based on health expenditure risk of enrollees. Prospective risk estimates are based on patient demographics and conditions documented from encounters occurring in previous and current years. The process of HCC coding can pose a challenge to physician groups because CMS requires new problem documentation each year to create a current profile of member risk. If severity is not documented in an accurate and timely manner, payment is reduced to the health plan, and increasingly to providers as well under their contracts with, or as sponsors of, these plans.
MedAptus has a demonstrated ability to leverage data within its Pro Charge Capture software to drive complementary, clinical data collection, such as with the company's PQRS and P4P functionality. Similarly, the MedAptus Risk Severity Toolkit now eases the process of HCC coding. The first step is an alert when a MA patient has an office visit and requires a severity evaluation and diagnosis documentation. From here the Toolkit profiles documented patient demographics and clinical conditions relevant to the HCC model, both prior and current year, for provider review during the encounter. The detailed Patient Severity profile also applies the HCC model to quantify the patient's severity scores based on those histories. Providers can quickly re-assess the patient's past and current clinical status to properly document new or continued manifestations requiring management. The Toolkit also includes analytical reports to compare patient severity scores over time across all at-risk health plans.
"Across our customers, it's evident that risk is shifting to providers based on clinically-based performance measures," said Dennis Bush, who manages MedAptus' Reporting and Analytics products. "In our development of the Risk Severity Toolkit, the immediate challenge we recognized is how to assure that clinicians properly assess and document conditions to correctly measure severity scores. Based on customer feedback, we have a practical solution, fitting naturally into the clinical workflow of providers."
The timing of this product release will help provider organizations on several fronts. Once ICD-10 goes into effect later this year, the number of diagnosis codes mapping to HCCs will increase, making this process even more complex for groups. Secondly, enrollment in private MA plans has been on an upward trajectory, with over 14 million covered lives in 2013, compared to 12 million only two years earlier. And CMS has aggressively audited, challenged, and recovered billions in excess premium payments to MA plans, who are in turn pressing providers for proper documentation.
"Traditionally, risk has been assumed primarily by purchasers and payers, but with the movement to value-based medicine and emerging ACO payment models, providers will absorb more risk, placing greater emphasis on the need for appropriate encounter documentation and both financial and quality management of that patient risk. Our Risk Severity Toolkit is a strong platform to accomplish these objectives given its leverage of demographic, visit and charge information within the MedAptus database," added Bush.
About MedAptus Corporation
MedAptus is the Gold Standard in the healthcare revenue cycle for achieving effective charge management, compliance and workflow efficiency. With offerings that include powerful and easy-to-use charge capture and management technologies, it is no wonder that many of the nation's most prestigious healthcare organizations rely on MedAptus for financial optimization. Our full-scale Professional, Technical, and Infusion applications increase revenue, enhance EMR investments, re-engineer manual processes and yield substantially improved productivity. For more information, visit www.medaptus.com, or call 617.896.4000.
Read more news on MedAptus.
MedAptus Contact: Jennifer Crowley
The IoT is changing the way enterprises conduct business. In his session at @ThingsExpo, Eric Hoffman, Vice President at EastBanc Technologies, discuss how businesses can gain an edge over competitors by empowering consumers to take control through IoT. We'll cite examples such as a Washington, D.C.-based sports club that leveraged IoT and the cloud to develop a comprehensive booking system. He'll also highlight how IoT can revitalize and restore outdated business models, making them profitable...
May. 26, 2016 04:15 PM EDT Reads: 2,720
SoftLayer operates a global cloud infrastructure platform built for Internet scale. With a global footprint of data centers and network points of presence, SoftLayer provides infrastructure as a service to leading-edge customers ranging from Web startups to global enterprises. SoftLayer's modular architecture, full-featured API, and sophisticated automation provide unparalleled performance and control. Its flexible unified platform seamlessly spans physical and virtual devices linked via a world...
May. 26, 2016 04:15 PM EDT Reads: 1,993
SYS-CON Events announced today that Super Micro Computer, Inc., a global leader in Embedded and IoT solutions, will exhibit at SYS-CON's 18th International Cloud Expo®, which will take place on June 7-9, 2016, at the Javits Center in New York City, NY. Supermicro (NASDAQ: SMCI), the leading innovator in high-performance, high-efficiency server technology, is a premier provider of advanced server Building Block Solutions® for Data Center, Cloud Computing, Enterprise IT, Hadoop/Big Data, HPC and ...
May. 26, 2016 04:15 PM EDT Reads: 345
SYS-CON Events announced today that Enzu, a leading provider of cloud hosting solutions, will exhibit at SYS-CON's 18th International Cloud Expo®, which will take place on June 7-9, 2016, at the Javits Center in New York City, NY. Enzu’s mission is to be the leading provider of enterprise cloud solutions worldwide. Enzu enables online businesses to use its IT infrastructure to their competitive advantage. By offering a suite of proven hosting and management services, Enzu wants companies to foc...
May. 26, 2016 04:15 PM EDT Reads: 2,151
As cloud and storage projections continue to rise, the number of organizations moving to the cloud is escalating and it is clear cloud storage is here to stay. However, is it secure? Data is the lifeblood for government entities, countries, cloud service providers and enterprises alike and losing or exposing that data can have disastrous results. There are new concepts for data storage on the horizon that will deliver secure solutions for storing and moving sensitive data around the world. ...
May. 26, 2016 04:00 PM EDT Reads: 1,201
SYS-CON Events announced today that BMC Software has been named "Siver Sponsor" of SYS-CON's 18th Cloud Expo, which will take place on June 7-9, 2015 at the Javits Center in New York, New York. BMC is a global leader in innovative software solutions that help businesses transform into digital enterprises for the ultimate competitive advantage. BMC Digital Enterprise Management is a set of innovative IT solutions designed to make digital business fast, seamless, and optimized from mainframe to mo...
May. 26, 2016 04:00 PM EDT Reads: 2,029
In his keynote at 18th Cloud Expo, Andrew Keys, Co-Founder of ConsenSys Enterprise, will provide an overview of the evolution of the Internet and the Database and the future of their combination – the Blockchain. Andrew Keys is Co-Founder of ConsenSys Enterprise. He comes to ConsenSys Enterprise with capital markets, technology and entrepreneurial experience. Previously, he worked for UBS investment bank in equities analysis. Later, he was responsible for the creation and distribution of life ...
May. 26, 2016 04:00 PM EDT Reads: 1,860
SYS-CON Events announced today that AppNeta, the leader in performance insight for business-critical web applications, will exhibit and present at SYS-CON's @DevOpsSummit at Cloud Expo New York, which will take place on June 7-9, 2016, at the Javits Center in New York City, NY. AppNeta is the only application performance monitoring (APM) company to provide solutions for all applications – applications you develop internally, business-critical SaaS applications you use and the networks that deli...
May. 26, 2016 03:45 PM EDT Reads: 2,282
Customer experience has become a competitive differentiator for companies, and it’s imperative that brands seamlessly connect the customer journey across all platforms. With the continued explosion of IoT, join us for a look at how to build a winning digital foundation in the connected era – today and in the future. In his session at @ThingsExpo, Chris Nguyen, Group Product Marketing Manager at Adobe, will discuss how to successfully leverage mobile, rapidly deploy content, capture real-time d...
May. 26, 2016 03:45 PM EDT Reads: 1,487
SYS-CON Events announced today that ContentMX, the marketing technology and services company with a singular mission to increase engagement and drive more conversations for enterprise, channel and SMB technology marketers, has been named “Sponsor & Exhibitor Lounge Sponsor” of SYS-CON's 18th Cloud Expo, which will take place on June 7-9, 2016, at the Javits Center in New York City, New York. “CloudExpo is a great opportunity to start a conversation with new prospects, but what happens after the...
May. 26, 2016 03:45 PM EDT Reads: 975
With major technology companies and startups seriously embracing IoT strategies, now is the perfect time to attend @ThingsExpo 2016 in New York and Silicon Valley. Learn what is going on, contribute to the discussions, and ensure that your enterprise is as "IoT-Ready" as it can be! Internet of @ThingsExpo, taking place Nov 3-5, 2015, at the Santa Clara Convention Center in Santa Clara, CA, is co-located with 17th Cloud Expo and will feature technical sessions from a rock star conference faculty ...
May. 26, 2016 03:45 PM EDT Reads: 2,486
IoT generates lots of temporal data. But how do you unlock its value? How do you coordinate the diverse moving parts that must come together when developing your IoT product? What are the key challenges addressed by Data as a Service? How does cloud computing underlie and connect the notions of Digital and DevOps What is the impact of the API economy? What is the business imperative for Cognitive Computing? Get all these questions and hundreds more like them answered at the 18th Cloud Expo...
May. 26, 2016 03:30 PM EDT Reads: 2,186
SYS-CON Events announced today the How to Create Angular 2 Clients for the Cloud Workshop, being held June 7, 2016, in conjunction with 18th Cloud Expo | @ThingsExpo, at the Javits Center in New York, NY. Angular 2 is a complete re-write of the popular framework AngularJS. Programming in Angular 2 is greatly simplified. Now it’s a component-based well-performing framework. The immersive one-day workshop led by Yakov Fain, a Java Champion and a co-founder of the IT consultancy Farata Systems and...
May. 26, 2016 03:30 PM EDT Reads: 3,931
SYS-CON Events announced today that Isomorphic Software will exhibit at SYS-CON's [email protected] at Cloud Expo New York, which will take place on June 7-9, 2016, at the Javits Center in New York City, NY. Isomorphic Software provides the SmartClient HTML5/AJAX platform, the most advanced technology for building rich, high-productivity enterprise web applications for any device. SmartClient couples the industry’s broadest, deepest UI component set with a java server framework to deliver an end-...
May. 26, 2016 03:30 PM EDT Reads: 2,004
Enterprise networks are complex. Moreover, they were designed and deployed to meet a specific set of business requirements at a specific point in time. But, the adoption of cloud services, new business applications and intensifying security policies, among other factors, require IT organizations to continuously deploy configuration changes. Therefore, enterprises are looking for better ways to automate the management of their networks while still leveraging existing capabilities, optimizing perf...
May. 26, 2016 03:00 PM EDT Reads: 1,177