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In the past, risk analytics were delivered to health plans online and to their provider networks in paper-based reports. Providers would have access to this information either well in advance or well after the actual encounter with the patient. To complicate the process even further, documenting both health diagnoses and care gap closures usually required multiple systems, multiple log-ins, and multiple processes that extended well after the encounter was over. The information was not updated until the documentation produced an adjudicated bill and then updated throughout the system.
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Dynamic Healthcare Systems has streamlined this entire process by deploying a solution that achieves interoperability between payers and provider systems. Algorithms are applied to risk and performance scores where it can have the quickest and most meaningful impact – at the point of care. Since the introduction of risk adjustment for Medicare Advantage, Dynamic has established a reputation for its risk-based analytics. Dynamic now utilizes a wealth of collected clinical data and embeds member-based information directly to the provider's EHR at the point of care.
"Dynamic's risk analytics provider application is designed to improve capture rates of diagnosis and quality measures, reducing the risk of receiving delayed or missing information that is required from providers," says Jim Corbett, Chief Strategy Officer. "This ensures better information to providers and, as a result, better care and improved accuracy of claims submittals."
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Timely data can also decrease Risk Adjustment Data Validation (RADV) issues. With an integrated process, health plans should see improved documentation with fewer retrospective chart reviews required. This integration will allow health plans to gather and analyze information faster, pinpoint under and over-reporting, and help identify risk and care gaps earlier.
Dynamic's robust suite of integrated solutions provides health plans and provider groups with an enterprise-wide platform that enables a strong risk adjustment strategy ensuring maximum and accurate risk-adjusted payments.
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