Andrew Wall, Chief Innovation Officer, Healthmap Solutions
Transitioning to population health management and value-based care models is a priority for any healthcare organization that assumes the risk for or manages the utilization of healthcare outcomes. Yet, the shift can pose tremendous challenges—especially when it comes to complex care management, where the conventional episodic, point-in-time solutions often fall short. Complex patients, who typically present with co-morbid conditions, require a more comprehensive approach to manage their care for better health outcomes. More often than not, payers and healthcare providers lack the necessary technology infrastructure, data aggregation, and analytical capabilities to manage their more complex patients effectively. However, these tools help deliver a better holistic, patient-centered treatment, optimize care and health outcomes, and better to manage costs.
Healthmap Solutions (Healthmap) is an NCQA-accredited Kidney Health Management (KHM) company serving health plans, accountable care organizations (ACOs), and provider groups seeking value-based solutions that improve the clinical care and financial performance of high-risk, high-cost populations. The company was founded in 2013 by a team of kidney health stakeholders, including patients, patient advocates, physicians, and healthcare executives. Healthmap was built on the belief that aligning incentives in a fragmented healthcare delivery system could improve consumers’ healthcare outcomes.
Healthmap’s KHM program incorporates big data, artificial intelligence, machine learning, and advanced analytics to identify and target people with or at risk of developing kidney disease.
We combine high-powered predictive analytics, care management expertise, and direct patient support to help health plans improve care outcomes, lower overall cost of care and financial risks, and improve revenue growth
Combined with clinical expertise, the company’s KHM program empowers healthcare providers with actionable, data-driven, clinically proven insights and patient-centered care recommendations. Providers, in turn, use this information to optimize care and outcomes for each patient. The company’s multidisciplinary Care Navigation team partners with healthcare providers and specialists to coordinate care and recommend medication modifications as warranted. The Care Navigators also connect directly with patients to provide support and information needed to help manage their kidney health as directed by their provider. The program results are measured and reported compared to value-based metrics, and changes to care and/or treatment plans are made to optimize quality, improve healthcare outcomes, and better manage costs.
Healthmap’s industry-leading KHM program’s tenets are early identification of chronic conditions, avoidance of adverse events, slowing disease progression, and expanding patient choice of care options, including greater access to in-home dialysis and transplants.
As the Chief Innovation Officer of Healthmap Solutions, Andrew Wall, says, “Advanced technology leveraged with clinical expertise and complex care management are powerful tools in helping to keep people at risk for a chronic condition healthier and living longer. Slowing disease progression allows for a seamless and well-planned transition to the next stage of care and improves the patient’s quality of life while helping manage costs.” The Healthmap suite of value-based KHM solutions includes risk-based medical cost management, quality reporting, identifying and closing care gaps, and risk adjustment/revenue optimization aimed at achieving the clinical and financial goals of health plans, ACOs, and provider groups.
Through Healthmap Solutions’ patient-centered approach, the company’s KHM program addresses the challenges of caring for people living with complex, chronic conditions. Care is coordinated, and medication managed to avoid adverse events that can lead to avoidable and costly ER visits and unplanned hospitalizations. Barriers to care that can interrupt treatment continuity, such as access to transportation and meal insecurity, are eliminated. Additionally, people in need of support for behavioral health issues are connected to the professional care provider they need. This high-tech/right touch approach is invaluable right now when maintaining safe access to care is critically important for this incredibly vulnerable population.
“We combine high-powered predictive analytics, care management expertise, and direct patient support to help health plans improve care outcomes, lower overall cost of care and financial risks, and improve revenue growth,” said Wall.