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Physmark's Solutions for Healthplans
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There are multiple software solutions of interest to healthplans: |
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ACO: With the active promotion of ACOs by CMS, private healthplans are also beginning to encourage their providers to form ACOs, to integrate coordination of care and reward providers based on quality of out comes. Since most ACOs will be anchored by a single hospital, healthplans will need to deal with multiple ACOs. PayerSoft-ACO is designed to serve multiple ACOs and also consolidate data from multiple ACOs, without adding to the data integration tasks of a healthplan’s over-worked IT department. |
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CPC: In managing chronic populations one lesson learned is that patient self-management is the best option, as long as they also have easy access to their physicians. CPC offers just that - tools to self-manage and direct access to their physicians using the virtual medical office. CPC will work in parallel with EMRs and other systems in place, making it easier for accessing medical data via the web and for comparative studies of results. |
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HealthKeys and Care Maps: HealthKeys is a new decision support program based on a patent pending chronic population model that can create maps showing effectiveness of various preventive care programs and their impact on costs. Healthplans can use this to identify the ACOs that offer the best quality of care and the lowest costs. Using best practices as a benchmark can help healthplans replicate them in other service areas as well. |
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Claims and Benefit Administration: PayerSoft has the usual claims processing and adjudication features, as well as benefit administration and web enrollment modules that healthplans and self-insured employers need to manage care delivery. |
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| Copyright 2006, 2009, 2011. Physmark Inc. Dallas, TX |
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