Improving Healthcare with Advanced Analytics and AI
Introduction to Advanced Analytics in Healthcare
This week, several health IT vendors announced new tools to apply advanced analytics, automation, and artificial intelligence to help providers and payers spot potential gaps across care settings by embedding real-time insights into existing workflows.
Boosting Coding Accuracy Across Care
Innovaccer is offering health plans a new platform integration that targets gap closure and streamlines risk adjustment with a proactive approach. Health plans have historically relied on disconnected tools and resource-intensive manual processes that pose compliance risks and increased costs. Combining prospective, concurrent, and retrospective reviews, payers can use the new platform, called 360-Degree Gap Closure, to leapfrog traditional data silos and close gaps across care provider offices, pharmacies, and patients’ at-home interventions.
The key to risk adjustment and quality improvement is seamless data exchange with provider EHRs. With the U.S. Centers for Medicare and Medicaid Services accelerating value-based care adoption, gap closure can improve coding accuracy with automation and enhance member outcomes with advanced analytics. "We are bringing a much-needed shift in how payers approach risk and quality," Abhinav Shashank, Innovaccer’s cofounder and CEO, said. "Instead of piecing together multiple vendors and solutions, health plans can now close gaps efficiently across the entire care journey, whether at a provider’s office, in pharmacies or through at-home test kits."
Sending Gaps-in-Care Alerts to Providers
Veradigm announced a gap closure workflow integration for its payer insights platform. The company said that more than 3,500 healthcare practices across the United States are now receiving gaps-in-care alerts from several national and regional health plans directly in their EHRs. With the alerts, providers can address risk and quality care gaps in their point-of-care workflows, which could enhance clinical decision-making for better patient outcomes.
"By embedding risk and quality-driven insights into provider workflows, we are fostering a more interconnected healthcare ecosystem that enhances efficiency and improves patient outcomes," Jay Bhattacharyya, Veradigm senior vice president and general manager, said. The alerts could also improve claims acceptance rates. With streamlined access to payer incentive programs, providers can earn on average $100 in incentive payments per patient gap addressed in the platform, creating an additional revenue stream.
Creating a Patient Insights Overlay for EHRs
MedeAnalytics, a healthcare enterprise data platform and analytics service, has formed a strategic partnership with Holon Solutions, a vendor of workflow integration technology, to develop an integrated patient insights platform that enhances care and reduces overall administrative burdens. The partners said in their announcement earlier this month that providers will see significant improvements in their operations and patient care quality, including an 80% increase in gap closure rates and a 5% improvement in revenue capture.
Their proprietary artificial intelligence sensor technology powers an overlay located on top of EHRs that provides additional patient data without deviating from clinicians’ existing workflows. The integration provides claims and social determinants of health data, which can lead to timely interventions for patients and improved efficiency for care teams. "Our partnership with Holon represents a pivotal moment in healthcare data management and analytics," said Steve Grieco, MedeAnalytics’ CEO. "This synergy not only leads to better patient outcomes and care quality but also optimizes value and increases revenue for both payers and providers."
Conclusion
In conclusion, the use of advanced analytics, automation, and artificial intelligence in healthcare is becoming increasingly important. By leveraging these technologies, healthcare providers and payers can improve coding accuracy, reduce gaps in care, and enhance patient outcomes. The integration of real-time insights into existing workflows is crucial for achieving these goals.
FAQs
- Q: What is the purpose of the 360-Degree Gap Closure platform?
A: The 360-Degree Gap Closure platform is designed to help health plans close gaps in care by streamlining risk adjustment and improving coding accuracy. - Q: How do gaps-in-care alerts benefit healthcare providers?
A: Gaps-in-care alerts enable healthcare providers to address risk and quality care gaps in their point-of-care workflows, enhancing clinical decision-making and patient outcomes. - Q: What is the patient insights overlay for EHRs?
A: The patient insights overlay is a technology that provides additional patient data on top of EHRs, enabling timely interventions and improved efficiency for care teams. - Q: What are the benefits of the partnership between MedeAnalytics and Holon Solutions?
A: The partnership aims to develop an integrated patient insights platform that enhances care, reduces administrative burdens, and improves revenue capture for healthcare providers.
