Navigation Links
DST Health Solutions Launches New RiskAnalyzer Software to Help Medicare Advantage Plans Manage Risk Adjustment
Date:2/19/2009

RiskAnalyzer Incorporates Johns Hopkins ACG System for Provider Profiling, Predictive Modeling, Resource Management and Rate Adjustment

BIRMINGHAM, Ala., Feb. 19 /PRNewswire/ -- DST Health Solutions today announced the launch of its new Medicare risk adjustment software, DSTHS RiskAnalyzer(TM). RiskAnalyzer uses claims experience to determine where provider coding is not capturing disease conditions under the Centers for Medicare and Medicaid Services Hierarchical Conditions Category (CMS-HCC) model. It provides an objective set of rules to prioritize provider and member records for chart audit through identification of potentially incomplete or inaccurate patterns of coding -- either retrospectively or prospectively.

RiskAnalyzer is part of DST Health Solutions' CareAnalyzer(TM) analytics solution, which helps health plans identify high-risk members for care management. RiskAnalyzer and CareAnalyzer support appropriate member management with integrated report views of cost, quality and risk.

"In 2007, CMS completed the phase-in of risk-adjusted payments for Medicare Advantage plans based on the CMS-HCC model," said Amy Salls, Business Solutions Director for Decision Support, DST Health Solutions. "The goal of risk adjustment was to pay Medicare Advantage plans based not only on member demographics, but also on health status. This means that plans with the most effective risk adjustment optimization programs will have revenue that more accurately reflects their true risk."

RiskAnalyzer is designed to help health plans evaluate claims based on the likelihood of missed diagnosis codes. The software can also help plans identify mid-year variances while there is still an opportunity to appropriately document member risk factors.

RiskAnalyzer incorporates the ACG System, a peer reviewed methodology for provider profiling, predictive modeling, resource management, and reimbursement rate adjustment. The ACG System provides a robust application for capturing disease burden and risk from medical claims. It also incorporates a unique pharmacy model that relates prescribing practices to patient morbidity, providing another route to pick up diagnoses that may have been missed by medical claims. The ACG System was developed by The Johns Hopkins University Bloomberg School of Public Health, and is distributed exclusively by DST Health Solutions.

About DST Health Solutions

DST Health Solutions, LLC delivers systems and services that help improve efficiency, reduce operational costs, increase speed to market, facilitate medical cost management and price containment -- improving both member experience and service for commercial health plans, consumer-directed plans, government plans (Medicare Advantage, Medicare Part D and Medicaid) and physician practices. DST Health Solutions' enterprise applications and ASP and BPO services include claims processing, member and provider management, benefit plan management, new product development, care management and medical management, and decision support/analytics supporting nearly 400 clients representing 40 million lives. For more information about DST Health Solutions, contact 800.272.4799, e-mail inforequests@dsthealthsolutions.com or visit www.dsthealthsolutions.com.

The information and comments above may include forward-looking statements respecting DST and its businesses. Such information and comments are based on DST's views as of today, and actual actions or results could differ. There could be a number of factors affecting future actions or results, including those set forth in DST's latest periodic financial report (Form 10-K or 10-Q) filed with the Securities and Exchange Commission. All such factors should be considered in evaluating any forward-looking comment. The Company will not update any forward-looking statements in this press release to reflect future events.


'/>"/>
SOURCE DST Health Solutions
Copyright©2009 PR Newswire.
All rights reserved

Related medicine news :

1. Penn study finds pro-death proteins required to regulate healthy immune function
2. UCLA researchers identify markers that may predict diabetes in still-healthy people
3. Air pollution linked to cardiovascular risk indices in healthy young adults
4. More proof needed of safety and quality of electronic personal health records
5. Health care incentive model offers collaborative approach
6. Loneliness is bad for your health
7. Mailman School of Public Health study examines link between racial discrimination and substance use
8. Green Tea May Brew Up Healthier Skin
9. For Health Info, Women Often Turn to the Web
10. Record Number of Americans Lack Health Insurance
11. U.S. Research Funding Continues to Flatten as U.S. Health Costs Climb - in August 31 Science
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... (PRWEB) , ... June 27, ... ... in the patient payment industry today announced its strategic partnership with Connance, ... system workflows. , The two companies’ proven, proprietary technology combine to provide ...
(Date:6/26/2016)... Battle Creek, Michigan (PRWEB) , ... June 26, 2016 , ... ... abuse, joined as sponsor of the 2016 Cereal Festival and World’s Longest Breakfast Table ... held in honor of the city’s history as home to some of the world’s ...
(Date:6/26/2016)... ... June 26, 2016 , ... Many women are confused ... endometriosis. These women need a treatment plan to not only alleviate symptoms and ... help for preservation of fertility and ultimately achieving a pregnancy. The specialists at ...
(Date:6/25/2016)... ... June 25, 2016 , ... "With 30 hand-drawn hand ... project," said Christina Austin - CEO of Pixel Film Studios. , ProHand Cartoon’s ... within Final Cut Pro X . Simply select a ProHand generator and drag ...
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary ... Work award to iHire in recognition of their exemplary accomplishments in worksite health promotion. ... Maryland Workplace Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... June 23, 2016 Roche (SIX: RO, ROG; ... for its Elecsys BRAHMS PCT (procalcitonin) assay as a ... septic shock. With this clearance, Roche is the first ... integrated solution for sepsis risk assessment and management. ... infection and PCT levels in blood can aid clinicians ...
(Date:6/23/2016)... LOS ANGELES , June 23, 2016 /PRNewswire/ ... (NASDAQ: CAPR ), a biotechnology company ... first-in-class therapeutics, today announced that patient enrollment in ... progrEssion in Duchenne) has exceeded 50% of its ... its enrollment in the third quarter of 2016, ...
(Date:6/23/2016)... , June 23, 2016 Bracket , ... launch its next generation clinical outcomes platform, Bracket eCOA (SM) ... held on June 26 – 30, 2016 in ... first electronic Clinical Outcome Assessment product of its kind to ... #715. Bracket eCOA 6.0 is a flexible platform ...
Breaking Medicine Technology: