Solution Analyzes Patient Risk, Care Opportunities and Provider Performance to Increase Effectiveness of Health Plan's Care Management Program
BIRMINGHAM, Ala., May 18 /PRNewswire/ -- DST Health Solutions(R) today announced that Itasca Medical Care, a Minnesota health plan, has successfully implemented CareAnalyzer(TM), its analytic solution suite that combines elements of patient risk, care opportunities and provider performance. CareAnalyzer helps health plans meet reporting requirements for the Healthcare Effectiveness Data and Information Set (HEDIS(R)) and effectively identify high-risk members for care management.
Itasca Medical Care, headquartered in Grand Rapids, Minn., is a Medicaid/Medicare Advantage health plan administered by Itasca County Health & Human Services. Its members include Minnesota residents of Itasca, Koochiching and Aitkin counties.
"We chose CareAnalyzer to help us efficiently meet HEDIS reporting requirements," said Brett Skyles, program director, Itasca Medical Care. "The system presents data in a very logical and easy to use manner, which saves us time and increases accuracy in reporting."
In addition to meeting HEDIS reporting requirements, CareAnalyzer incorporates predictive modeling to help health plans identify high-risk members with chronic conditions such as diabetes, asthma or lower back pain. High-risk members then may be enrolled in care management programs that include preventive health screenings and treatment plans tailored to their condition.
CareAnalyzer incorporates the Johns Hopkins ACG(R) (Adjusted Clinical Grouper) Case System, a peer reviewed software tool for provider profiling, predictive modeling, resource management, and reimbursement rate adjustment. The ACG System was developed by The
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