Healthcare providers are at a critical juncture, newly responsible for both the quality and cost of care that they furnish while also being asked to gain a deeper understanding of their patients’ risk factors. Recent studies demonstrate the importance of documenting and studying the SDOH, or the underlying non-medical factors that influence and determine a patient’s health status and health outcomes.

Osler Health already had a third-party analytics vendor in place and required an integration engine for its 27 practice sites that had to be connected to provide consolidated patient data. The clinical staff needed an uninterrupted and near-real-time data exchange for their panel of 350,000 lives to easily complete the required documentation and reporting procedures.

A leading Accountable Community of Health (AHC) based out of Pierce County, Washington wanted to tighten the care coordination process for their partners in the community distributed across many practice sites. The ACH was challenged to integrate data from different kinds of electronic health records (EHRs) and close referral loops for hundreds of patient records.

A patient-centered healthcare approach powered by advanced analytics can enable providers to move beyond treating illness to facilitating proactive care. However, research shows that many patients discharged from a hospital return within 30 days due to inadequate care.

A leading Midwestern clinically integrated network (CIN) has more than 4,000 health practitioners and 200,000 patients in value-based care arrangements. The CIN previously struggled to determine which patients were at high risk for readmittance and to efficiently coordinate care.

The growth of Medicare Advantage (MA) plans is among one of the many challenges health plans face as they aim to optimize member care while maintaining high-quality compliance standards.

A leading PHSO with more than 3,500 providers and 310,000 patients sought to improve care coordination, manage resources, monitor performance, and engage patients with data-driven strategies.

Payer compliance deadlines for the CMS Interoperability and Patient Access final rule are fast-approaching. The rule, which CMS hopes will create industry-wide, barrier-free data exchange, will require payers to give patients easier access to their healthcare data as well as implement provider directory APIs that third-party programmers can use to create applications for members. In addition to true data transparency, the rule will help payers leverage data to identify gaps in care, execute timely interventions, and get new insights for population health management.

A leading Iowa-based PHSO sought to reduce its overall healthcare expenditures by optimizing its skilled nursing facility (SNF) utilization and costs across the network. Increases in the average length of stay (LOS) and daily charges meant utilization reimbursements varied, and the PHSO struggled to deliver cost-effective care.

In today’s healthcare landscape, payers and providers are equally responsible for addressing the needs of members, who expect high-quality, coordinated care experiences. Outreach campaigns, educational resources, and medication adherence can go a long way toward improving clinical outcomes and member satisfaction—two key factors of plan performance.