Andrew Wall, President & COO, Healthmap Solutions
Population Health Management is a critical competency in a value-based healthcare world. Overcoming the challenges of building and deploying a population health program, such as legacy systems, aggregating disparate data, analyzing and synthesizing the data into actionable insights, and coordinating care often stands in the way of health plans and provider networks. Healthmap Solutions, a Population Health Management (PHM) company with proven results for managing vulnerable, complex patients, offers a solution. The company uses artificial intelligence, machine learning, and proactive patient-centered care management across a spectrum of flexible specialty care management solutions, which include Medical Cost Management, Quality Reporting/Close Care Gaps, and Risk Adjustment/Revenue Optimization.
Backed by COMPASS, a HITRUST certified and a National Committee for Quality Assurance (NCQA) pre-validated population health management platform, the company’s flagship program known as Kidney Health Management (KHM) provides quantifiable, predictable, and actionable visibility into patients with or at risk of developing chronic kidney disease (CKD) and End- Stage Renal Disease (ESRD), improving value-based performance right down to the individual patient.
The proprietary and proven COMPASS platform include an interoperability tier providing easier access to disparate data sources, a decision support system, analytics, and targeting engine, and an omni-channel model that optimizes provider and member engagement. Its powerful predictive capabilities are the result of over thousands of algorithms developed with the clinical experts that analyze claims, lab results, encounter, and even retail data. COMPASS takes it a step further by using advanced machine learning to predict who is at risk for the disease, disease progression, and those at risk for preventable and planned events like dialysis months in advance.
It then determines the most clinically appropriate sequence of events to proactively intervene and care for them, driving down costs and improving the quality of care and outcomes.
Healthmap Solutions integrates the power of the COMPASS platform’s superior predictive analytics with the company’s multidisciplinary Care Navigation Team to apply evidence-based guidelines at a patient-specific level to address their physical, behavioral, and social determinants of health needs at scale. Included is a critical medication management component that identifies and flags medication issues and recommends course corrections. The Care Navigation Team works with the patient’s healthcare providers to coordinate care. They connect with patients to provide the support and information patients need to be empowered and engaged in their healthcare. Progress is measured and reported against value-based, quality, and outcomes metrics, providing the most up-to-date information on a patient’s health and progress and that of the full population under management. Modifications to care and treatment plans are made to optimize quality and outcomes for each patient, and best manage costs.
“We know early detection and clinically appropriate interventions are the best means of treating and slowing the progression of CKD and providing a smooth transition into renal replacement therapy when clinically necessary. This improves the quality of life for the patient and the cost of providing care for our partners,” said Andrew Wall, President and Chief Operating Officer at Healthmap Solutions. “Our KHM solutions are tailored to individual patient needs and supported by our Care Navigation team which works collaboratively with providers to ensure the right care is delivered at the right time in the right place, improving outcomes and costs.”
Healthmap Solutions KHM programs are scalable, easily customized, and implemented with no network disruption, integrating seamlessly into existing infrastructure and systems. Healthmap Solutions KHM solutions are designed to meet the complex needs of health plans and healthcare networks in a population health model and to drive meaningful results.
“We believe in what we do and our ability to deliver on our promise, so we take on financial risk for our performance,” Wall adds. Healthmap Solutions also provides similar integrated programs across the full range of specialty health population management.