CMS Quality Measures, ACO Reporting, Claims Reporting

Modern data applications go far beyond the retroactive reporting the industry is used to and bring data management options and predictive capabilities that can benefit both care providers and patients. By McKinsey's estimate, the systematic application of  data analytics to the US healthcare system could reduce industry spending by $300 - $450 billion annually.

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We understand that healthcare organizations have lagged behind other industries when it comes to cloud adoption and data modernization due to challenges such as privacy of health information, data security, siloed data, and budget constraints.

Adopting cloud infrastructure and modernizing data management infrastructure is necessary to meet CMS and MIPS reporting requirements as well as helping transform provider networks within the industry; transitioning from a fee-for-service model toward value-based care. In short, it can deliver on the promise of lowering healthcare costs while revealing ways to deliver superior patient experiences, treatments, and outcomes.

Our experience in this space comes from ongoing projects with hospitals, post-acute providers, health insurance plans, community care organizations, and others. Some of the solutions we have developed include:

Physician performance management systems based on CMS Quality Measures which can be sliced and diced by risk adjusted APR/DRG codes

Patient encounter data warehouses that gracefully process dirty and incomplete data and provide a 360-degree view of a patient

CMS API integration, FHIR standards

HL7 support and transformation

Integration of claims data

Migrations from NextGen to Epic

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