My esteemed colleague, Dr. Alice Petrulis, Chief Medical Officer at KePRO, and I collaborated last Wednesday on a webinar discussing how KePRO has implemented MEDecision’s Nexalign iEXHANGE to reduce its overall cost-per-review and increase provider satisfaction through rapid turnaround. The company has really done some very innovative work with Nexalign iEXCHANGE on this project. It first implemented the approach with one customer in 2005 and by 2008 it had resulted in more than 90,000 auto-approvals and a cost savings of $250,000. As Dr. Petrulis explains in the webinar, KePRO is now extending the procedure throughout across its organization.

You can link to the webinar archive here.

MEDecision’s Vice President of Content Development Marie DiPrinzio joined Dr. Lavdena Orr, the Chief Medical Officer at DC Chartered Health Plan in Washington D.C., and the plan’s Senior Director, Rosalyn Stephens, for a presentation at the recent AHIP Medicaid Conference. The three discussed how Chartered has successfully implemented MEDecision’s Alineo collaborative health care management platform to manage care for its rather challenging Medicaid population.

Some of the difficulties in managing Medicaid patients stem from the fact that they are frequently transient; they may change addresses regularly or be homeless altogether. In addition, as a rule, Medicaid members can change their insurance coverage monthly, so they often bounce in and out of Chartered’s system. Chartered’s population is also culturally diverse and sensitive, representing different ethnic backgrounds, cultures and languages; many have limited resources.

With Alineo, Chartered is better able to manage its members simply by being better able to keep track of them. The technologies provide a centralized view of each patient that is available to care team members no matter how frequently or infrequently a specific member has touched the Chartered system. They have at their fingertips a comprehensive view of prior visits, existing conditions, treatments, medications, tests and so on, all in one centralized resource — no need to access a variety of systems and technologies. Chartered has also found that Alineo has allowed it to improve communication internally and with providers and other entities. In some instances, the system can help to facilitate communication between the care team and a patient’s caregiver even if the individual patient can’t communicate themselves. 

Chartered’s experience with MEDecision technology is a fascinating case study and an excellent example of how information technology can improve health care management and delivery. Apparently the 60 or so payer attendees at the presentation agreed as each was very well engaged in an energetic follow up conversation. Congratulations to Marie, Lavdena and Rosalyn on a job well done.