TAMPA, Fla. – Sept. 5, 2012 – Accountable care organizations (ACOs) that deploy 360ACO® from MedHOK, one of the healthcare industry’s fastest-growing software companies, are well-positioned to reduce hospital readmissions and meet quality outcomes as required to benefit from shared savings under the Centers of Medicare and Medicaid (CMS) program.
MedHOK offers fully NCQA–certified software for HEDIS®, pay-for-performance (P4P) and disease-management-performance measures. The company has more than 18 million lives in production and is on track to double this number within the year.
“Hospital readmissions are a major cost driver in Medicare, accounting for a startling $17.5 billion in additional inpatient spending each year. To combat this, CMS is incentivizing ACOs to take steps to reduce readmissions and improve follow-up care for patients with acute myocardial infarction, heart failure and pneumonia,” said Anil Kottoor, president and CEO, MedHOK. “The challenge for many ACOs will be tracking quality outcomes and facilitating the improved coordination of care necessary for timely interventions. MedHOK’s 360ACO overcomes those challenges and positions ACOs to share in the resulting savings.”
MedHOK’s 360ACO integrates patient information in real time and makes it immediately available to hospitals, physicians and other participating providers. The disease and case management modules allow the ACO to better manage care for high-risk patients, reducing unnecessary utilization and encouraging improved patient self-management. Further, 360ACO enables real-time monitoring of quality performance to ensure the ACO is on target to meet the rigorous quality standards that will allow it to share in any reductions in Medicare fee-for-service expenditures.
MedHOK’s integrated care management, quality and compliance platform facilitates improved clinical outcomes and care coordination while enhancing quality measures, compliance and financial performance. It accomplishes this by:
- Providing real-time access to Star, HEDIS, P4P, and proprietary quality and performance measures, helping plans and providers to accurately monitor in real-time the data they need to achieve and maintain high-quality ratings
- Triggering interventions when care gaps are identified, in particular for patients with multiple comorbidities and chronic conditions
- Utilizing predictive analytics models to generate profiles based on clinical, quality and financial data for member, provider and local populations
- Calculating risk scores for every member, enabling timely predictions of those at the highest risk and more accurate forecasting of care costs and utilization
- Continuously monitoring for and addressing regulatory changes from CMS and state Medicaid agencies, ensuring clients stay ahead of the compliance curve
“MedHOK’s 360ACO is an end-to-end technology solution that positions ACOs to thrive in this new environment of care, quality and compliance,” said Kottoor. “By utilizing 360ACO, providers will be able to intervene before readmissions are necessary, resulting in increased savings and improved patient care.”
Tampa, Fla.-based MedHOK has more than 18 million lives in production and expects to double that number in 2012, making it one of the healthcare industry’s fastest-growing software companies. It offers a cloud-based integrated software platform for care management, quality and compliance that enables physicians, ACOs, PCMHs, payers and TPAs to manage and measure care against national quality standards for optimal outcomes. Its innovative modular software helps healthcare organizations meet quality, care and compliance objectives across business lines by facilitating real-time information sharing with all stakeholders to address disease management and care coordination, clinical quality and utilization review, and quality and financial measures. ICD-10 compliant, HIE-ready and securely accessible on any device, the MedHOK platform is user-friendly, rapidly deployed and easily configurable for a low total cost of ownership and rapid return on investment. It holds 2012 HEDIS®, Pay for Performance and Disease Management performance measures certification.