Comply with Regulatory Requirements

Comply with Regulatory Requirements

Turn Regulations into Revenue Opportunity

As health plans engage in government programs, they become responsible for more complex member populations. Meeting regulatory requirements isn’t just a necessity any more—it’s a growth opportunity.

By embracing requirements within various government programs, health plans can help develop more effective strategies to improve outcomes while optimizing return on their initial investment.

 

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Capitalize on regulatory risk by effectively managing member populations

With uniquely high-cost, complex populations, including government beneficiaries, health plans need population-specific, data-driven programs to zero in on clinical and financial risk. Although these types of programs can be intricate, health plans can use existing compliance requirements as a roadmap to develop effective care plans.

Medecision helps health plans create successful care management programs and turn regulatory risk into ROI with solutions to:

  • Support the cross-system transparency needed to implement, manage and measure population-wide health improvement initiatives
  • Automatically populate data directly aligned with government-specific programs and reports
  • Identify and influence high-risk and rising-risk members quickly to drive effective interventions
  • Implement patient-centered care coordination workflows to meet quality and cost requirements
  • Leverage clinical and financial insights to inform future risk contracting efforts and compliance

Using requirements as the foundation for a population health management strategy can help health plans increase reimbursements, decrease the total cost of care and improve quality and member satisfaction, while realizing ROI.

MEDECISION’S ADVISORY SERVICES TEAM OFFERS EXPLORATORY ASSESSMENTS TO HELP YOU IDENTIFY OPTIONS AND STRATEGIES TO ACHIEVE CLINICAL AND FINANCIAL SUCCESS.

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