Alineo is a flexible, long-term solution that can accommodate changing organizational needs and evolving technical requirements.

Alineo is a collaborative health care management platform for case management, disease management and utilization management. This completely re-architected solution gives health care payers a simplified and smart process for analyzing data to identify high-risk patients. It enhances this information with clinical intelligence and automates the administration of health care programs and best practices.

Alineo features a simplified user experience to enhance workflow, efficiency and overall productivity — all while maintaining an organization’s business rules and practices. As a result, it helps to improve the overall quality, safety and affordability of health care.

Key Alineo Benefits:

• Analyzes and Identifies High Risk Patients
  Alineo provides intuitive predictive modeling tools to identify patients who can immediately benefit from case and disease management programs, which improves clinical and cost outcomes
• Applies Clinical Knowledge
  Alineo delivers turnkey clinical knowledge and programs based on embedded clinical content to present the best care plans, which improve clinical consistency
• Automates Health Care Program Administration
  Alineo allows health care payers to automatically and intelligently administer and evaluate individual member and population-wide health care programs, including approvals, referrals and extensions

Alineo Components:

• Automated Approvals 
  Client-defined business rules that automatically evaluate care requests to determine whether the request should be approved or pended for further review
• Care Management Analytics
  Identification and stratification of target patients and populations to set appropriate levels of intervention and improvements for a member’s care
• Clinical Intelligence
  A set of clinical rules, based on evidence-based medicine, reference materials, industry-standard best practices and physician expertise, for clinical consistency in care management processes
• Clinical Programs 
  A series of case and disease management clinical care pathways that enable the efficient implementation of care management programs that reduce costs and improve the quality of care
• Clinical Summaries
  Clinically validated, payer-based electronic health records derived from claims and care management data
• Correspondence
  Integration with a robust third-party correspondence product that allows organizations to efficiently define and maintain letter templates in Microsoft Word
• Reporting
  A set of standard report templates and the ability to create ad hoc reports for care management data that operates within Alineo
• Clinical Criteria
  A set of clinical criteria that assists Alineo users in determining the appropriateness of care