Alternatives to AxisCore

CORE unites various sectors of the industry to speed up automation and enhance business processes that simplify healthcare for patients, providers, and health plans alike. By leveraging the most reliable source of provider and member information, CAQH empowers healthcare organizations to cut expenses, enhance payment accuracy, and revolutionize their business operations. In the rapidly changing healthcare environment, ongoing advancements in payment and claims processing are crucial. Healthcare providers and health plans nationwide rely on CAQH to gather and oversee professional data, verify primary sources, and keep track of sanctions. Consequently, this leads to more efficient administration, improved regulatory compliance, and superior management of provider information. Ultimately, the collaboration fosters innovation and ensures that all stakeholders benefit from a more effective healthcare system.

A data-driven solution for managing claims and remittances specifically designed for healthcare providers looking to streamline their workflows, enhance resource efficiency, minimize denial rates, and expedite cash flow. Boost your initial claim acceptance rate significantly. Our all-inclusive edits package ensures you remain compliant with evolving payer guidelines and regulations. Increase your team's efficiency with user-friendly, exception-based workflows and automated procedures. Your personnel can conveniently utilize our adaptable, cloud-based platform from any device. Effectively manage your secondary claims volume through the automated creation of secondary claims and explanations of benefits (EOB) derived from the primary remittance advice. Leverage predictive artificial intelligence to identify and prioritize claims that require attention, allowing for quicker error resolution and minimizing denials before submission. Achieve a more efficient claims processing experience. Additionally, print and distribute primary paper claims, or compile and send collated claims along with EOBs for secondary submissions. This holistic approach not only enhances operational efficiency but also promotes better financial performance for healthcare providers.

Our comprehensive platform provides fully integrated health plan solutions that add value and reduce the complexities of healthcare for employers, members, providers, and payers alike. Valenz combines member-focused services with insights derived from data, creating connections through personalized assistance that leads to high-quality care and enhanced outcomes. We prioritize early and frequent engagement through effective education, support, and services designed to prevent more severe and costly health issues down the line. By choosing Valenz, you can foster a healthier member population while consistently achieving cost savings for both plans and members year after year. To access the transparency and tools necessary for making quality-driven, cost-effective decisions, let’s discover your pathway to more efficient healthcare today. Additionally, the Valenz healthcare ecosystem optimization platform features a suite of fully customizable solutions that are all integrated within a single strategic framework, providing in-depth visualization of cost, quality, and utilization opportunities, ensuring you are equipped to navigate the healthcare landscape effectively.

HealthRules® Payer represents a cutting-edge core administrative processing system that offers transformative features for health plans across various types and sizes. For over a decade, health plans utilizing HealthRules Payer have effectively capitalized on market opportunities, maintaining a competitive edge. What sets HealthRules Payer apart from other core administrative solutions is its innovative application of the patented HealthRules Language™, which resembles English and introduces a groundbreaking methodology for configuration, claims management, and information transparency. This system empowers health plans by enabling them to expand, innovate, and outperform their peers more effectively than any other core system available today. As a result, HealthRules Payer not only streamlines operations but also fosters a culture of agility and responsiveness within health organizations.

PLEXIS offers a comprehensive suite of top-tier applications designed to equip payers with the advanced capabilities required for contemporary core administrative systems. These applications encompass functionalities such as real-time benefit management, adjudication, automated EDI transmission, and self-service customer portals, ensuring that PLEXIS Business Apps meet all your needs. The Passport feature facilitates crucial connections between core administration and claims management systems, PLEXIS business applications, custom applications, and existing internal systems. Its adaptable API layer allows for real-time integration with various portals, automated workflow tools, and business applications, ensuring that connectivity knows no bounds. By employing this centralized, modern core administration and claims management platform, you can enhance workflows effectively. This approach enables the efficient processing of claims while simplifying the complexities associated with benefit administration, resulting in a swift return on investment and the ability to provide exceptional customer service. Ultimately, PLEXIS empowers organizations to thrive in an increasingly complex healthcare landscape.

PlanXpand™ is the specialized transaction processing engine developed by Acero, which serves as the backbone for all products aimed at health benefits administrators. With this innovative engine, clients have the flexibility to implement Acero’s offerings either all at once or gradually over time. Beyond simply selecting from our standard range of products, administrators have the option to harness PlanXpand™ to create tailored solutions that enhance their current system functionalities. Acero’s distinctive, integrated solutions utilize a Service-Oriented Architecture, enabling health benefits administrators and insurers to augment their existing adjudication platforms with new features and capabilities. Furthermore, our advanced design and engineering facilitate real-time adjudication for all claim types, directly interacting with the core claims system, which leads to improved processing accuracy, increased customer satisfaction, and a reduced necessity for claims adjustments. This adaptability and precision in processing claims ultimately positions Acero as a leader in the health benefits administration sector.

Create, enhance, sustain, and market your network all through a single integrated platform. Utilize competitive insights to bolster your market position effectively. Standardize and refine provider information to facilitate easier searches. Evaluate network performance using metrics related to accessibility, cost, and quality. Provide engaging and feature-rich solutions for provider searches. Gain a deeper understanding of your network's financial health. Construct and improve networks that are competitive, accessible, and provide high value to capture market share and fulfill the needs of your members. Monitor competitor movements and market prospects to sharpen your network strategy, pinpoint optimal providers to stay competitive, and convey the strengths of your network. Simplify your provider directory, plan design, and benefit consulting through quicker and more dependable provider network data. Design tailored networks that align with each client's specific objectives, risk tolerance, and desired provider access, ensuring a comprehensive approach to network management. This complete suite of features not only enhances operational efficiency but also strengthens your overall market presence.

Leveraging AI as a foundational strategy for payers, providers, and pharmacy benefit managers involves developing cloud-based products and platforms that enhance operational efficiency. A "healthcare digital platform" represents the amalgamation of various applications and cutting-edge technologies to deliver customized healthcare solutions that positively influence business results, marking a progressive and expedited shift away from traditional core administration processing systems (CAPS). To gain insights into how digital platforms and emerging technologies can help meet business goals, as well as their effects on healthcare payer key performance indicators (KPIs) and the overall appeal of these platforms, Infosys collaborated with HFS to survey 100 C-suite healthcare payer executives across the United States. This initiative aims to shed light on the evolving landscape of digital healthcare solutions and their potential for transforming industry practices.

Envolve is committed to transforming healthcare by leveraging strategic partnerships and extensive experience to deliver value-based and cost-effective care solutions. The services offered by Envolve MSO equip organizations with essential strategies, skilled personnel, and streamlined processes aimed at implementing value-driven, affordable healthcare and facilitating genuine transformation in the sector. As a prominent provider of healthcare management services, we infuse innovation and expertise to enhance performance within outcomes-oriented and value-based reimbursement frameworks. Our comprehensive healthcare management services improve both quality and efficiency in care delivery through top-tier business administration services, effective data usage, clinical excellence, and robust operational support. By investing in pioneering benefit designs across a variety of products nationwide, Envolve significantly contributes to publicly funded, marketplace, and commercial programs that enhance individuals' health and overall quality of life. This commitment to innovation and improvement positions Envolve as a leader in reshaping the future of healthcare for all.

AssureCare, a privately-held healthcare technology company, provides innovative care management solutions for commercial and health and human service providers. AssureCare's flagship platform, MedCompass is used by healthcare providers across the United States to provide end-to-end care management for millions. MedCompass transforms healthcare management through streamlining workflows and automating processes. This allows care professionals to make better decisions and achieve lower costs and a significantly improved quality of care. AssureCare is a leader in the development of modular, seamless solutions that improve patient outcomes and reduce unnecessary costs associated with population health management.

Speed up payment processes while minimizing administrative tasks. With over 8,000 payer connections and established collaborations with more than 650 practice management vendors, our claims management solutions lead to a reduction in pending claims and decreased need for manual efforts. Efficiently and accurately send claims for various services, including professional, institutional, dental, and workers' compensation, ensuring prompt reimbursement. Tackle the evolving landscape of healthcare consumerism by delivering a smooth and transparent financial experience. Our patient engagement tools enable you to facilitate informed discussions around eligibility and financial obligations, while also lowering obstacles that could affect patient outcomes, ultimately fostering better healthcare experiences.

Specialty and rare diseases often encompass patient populations that are not clearly defined, including individuals who remain undiagnosed or face misdiagnoses, along with healthcare providers who may lack knowledge about these conditions and their various manifestations, resulting in treatment pathways that are poorly understood. IPM.ai operates as an Insights-as-a-Service (IaaS) firm, dedicated to empowering leading life sciences organizations to gain deeper insights into patient care and enhance the quality of life for those affected through the development, clinical research, and commercialization of therapeutic solutions. By predicting market size, analyzing the competitive landscape, and estimating potential return on investment, companies can optimize their commercialization strategies. Additionally, the platform identifies undiagnosed and misdiagnosed individuals who could benefit from early disease interception and therapeutic measures. It employs statistical models to gauge the prevalence of specific diseases within certain patient populations at any given moment. Furthermore, IPM.ai helps pinpoint physicians who are adept at diagnosing and treating these ideal patients, while also influencing other healthcare providers to enhance overall patient outcomes. This comprehensive approach ultimately aims to bridge the gap in understanding and addressing the needs of those with rare diseases.

Veradigm Payerpath offers a comprehensive suite of revenue cycle management solutions designed to enhance financial performance for healthcare organizations by improving communications with both payers and patients, ultimately increasing practice profitability across various specialties and sizes. By addressing issues such as incomplete information, incorrect coding, and data entry mistakes, the system ensures that claims are submitted cleanly and accurately. It also guarantees that claims are correctly coded, devoid of missing details, and free from errors before submission. With advanced analytical reporting, practices can benchmark their performance against state, national, and specialty peers, enabling them to optimize productivity and boost financial outcomes. Additionally, Veradigm Payerpath helps remind patients about their appointments while confirming their insurance coverage and benefits, streamlining the process. The platform further automates the billing and collection of patient responsibilities, making it easier for practices to manage finances. Notably, Veradigm Payerpath's integrated solutions are agnostic to practice management systems, ensuring seamless compatibility with all major PM platforms, which enhances its versatility in various healthcare settings. This flexibility allows practices to focus more on patient care while efficiently managing their financial operations.

QuickCap, developed by MedVision Solutions, is a comprehensive management tool designed to handle both administrative and clinical data processes, enabling users to prioritize their business operations instead of getting bogged down by paperwork. This solution offers scalable control over workflow and information, allowing for more efficient work practices. Users benefit from a customizable dashboard that enhances usability and automates processes for increased speed. Additionally, QuickCap simplifies claims handling, making the overall work experience smoother for users. Furthermore, it provides valuable analytics that assist users in easily assessing the profitability of individual providers. This combination of features ultimately empowers organizations to operate more effectively and make informed decisions.

naviHealth is revolutionizing senior-centered care by collaborating with health plans and providers to enhance the care transition process through innovative technology. Our focus is on simplifying transitions and improving overall care experiences for seniors, offering valuable news, insights, and expert analysis. With our proprietary tools for post-acute care planning, naviHealth provides clinical support that not only boosts patient recovery but also minimizes avoidable medical expenses. Our approach allows partners to manage care transitions more effectively, utilizing our specialized patient care management system. By integrating in-market clinical support with cutting-edge technology, we facilitate a smoother recovery journey for patients, enhance satisfaction levels, and reduce unnecessary costs associated with post-acute care. Furthermore, naviHealth’s dedicated care coordinators play a crucial role in maintaining seamless communication among patients, their families, and healthcare providers, ensuring that everyone is on the same page throughout the recovery process. This interconnected support system ultimately leads to better health outcomes and a more efficient care experience.

Personify Health stands as a pioneering personalized health platform, delivering integrated solutions that encompass health, wellness, and navigation services. Established from the merger of Virgin Pulse and HealthComp in November 2023, the company seeks to streamline the healthcare experience by offering personalized, interconnected, and user-centric services. Their all-encompassing platform features various offerings, including health plan management, comprehensive wellbeing initiatives, and care navigation assistance, all crafted to encourage individuals to take a more active role in their health journey. Through the use of data-driven personalization and scientifically-supported strategies, Personify Health not only aids businesses in maximizing their healthcare investments but also enhances health outcomes for their members. By focusing on individual needs and preferences, Personify Health is setting a new standard in the healthcare industry.

The budgeting process in hospitals is fundamentally flawed and inefficient. Typically, these organizations invest anywhere from three to six months and over 100,000 hours to create a budget that often misses the mark by tens of millions of dollars and becomes outdated as soon as it is completed. There must be a more effective solution, and such a solution exists. StrataJazz stands out as the most comprehensive Advanced Planning tool available, fundamentally transforming the way healthcare providers approach planning, budgeting, forecasting, and managing both operating and capital expenses. As a result, the planning process becomes not only more efficient but also more accurate and responsive to change. By implementing top-down rolling planning methods, integrating relevant cost data seamlessly, and utilizing advanced automation, workflow, and analytical best practices, StrataJazz fosters a collaborative and results-driven budgeting process that is markedly more precise and considerably less time-consuming. This innovative approach ultimately empowers healthcare organizations to allocate resources more effectively and enhance their financial performance.

Therap stands out as the foremost provider of electronic documentation and record-keeping solutions for long-term care services catering to individuals with Intellectual or Developmental Disabilities. This comprehensive web-based application suite is meticulously crafted to meet the diverse needs of organizations that assist these individuals, encompassing aspects such as planning, documentation, reporting, communication, and billing across various environments, including home and community-based services (HCBS). By leveraging secure cloud technology, the Therap system enhances service quality in settings like day programs, assisted living facilities, ICF/IID facilities, community support programs, and state agencies. It facilitates effortless daily communication and reporting among states, administrators, healthcare providers, case managers, quality assurance teams, and families, ensuring that everyone involved is well-informed and connected. Ultimately, Therap's innovative approach fosters a more coordinated and efficient support system for those with intellectual and developmental disabilities.

The SMAF tools have been consolidated into a single, shareable information system, enabling automated calculations of SMAF profiles. This system offers reports that aid in analyzing results and creating assistance plans, making it straightforward for healthcare professionals to use. Additionally, it enhances networking and service organization without requiring any software installation. The iSMAF, marking the fifth significant version of our software, operates as web-based software that digitizes established clinical tools and processes linked to the SMAF tool. Specifically designed for Quebec, the iSMAF edition features the PRISMA-7, the SMAF evaluation grid, the social-SMAF, a generator for Iso-SMAF profiles, and a care table. Furthermore, it provides various functions that allow clinicians and managers to produce reports on specific subjects or groups, facilitating a comprehensive understanding of the establishment, the progression of profiles over time, or comparisons between different groups based on their profiles. This integration represents a significant advancement in streamlining the management of health assessments and planning.

Since its inception in 1992, Orion has been dedicated to delivering technology solutions and professional services aimed at enhancing workflows within the addictions and mental health fields. The premier software offering from Orion, the cloud-based AccuCare EHR, was developed by a skilled team of clinicians and engineers focusing on optimizing essential aspects of agency operations, such as clinical care, financial management, billing, administrative tasks, and research analysis. AccuCare offers a comprehensive suite of features, including tailor-made screenings and assessments, admission and discharge processes, treatment planning, progress notes, telehealth services, e-prescribing capabilities, scheduling, electronic billing, and custom reporting functionalities. Additionally, the AccuCare Web-Based Practice Management System is backed by a team of dedicated specialists who are prepared to address any inquiries regarding system usage in relation to existing documentation and billing procedures. Included in the subscription are customer support services, as well as regular automatic updates and upgrades that incorporate real user feedback, ensuring that the software remains responsive to the needs of its users. This commitment to continuous improvement and user satisfaction highlights Orion's dedication to advancing the effectiveness of mental health and addiction services.

E-HAS serves as a comprehensive Online and Offline Hospital Administration and Management Information System tailored for healthcare organizations. This system boasts data warehousing and business intelligence features aimed at fostering sustainable growth within hospital operations while automating processes to reduce labor costs and enhance precision. Notably, E-HAS introduces a responsive design that is unprecedented in any Health Information System, along with support for mobile and tablet applications. Its architecture is versatile enough to accommodate various hospital types, whether specialty or general, and offers the capability to function online or offline, especially beneficial for networks of distributed hospitals. Furthermore, the data mining features empower healthcare professionals to make informed decisions. E-HAS stands out as a groundbreaking solution, encompassing a full suite of features that streamline hospital management, all while ensuring a rapid return on investment. This innovative approach not only enhances operational efficiency but also positions healthcare organizations for future success.

The Amadeus Digital Care Record (DCR) offers a thorough solution that aims to give healthcare professionals a consolidated perspective of patient data right when it is needed. By merging information from various healthcare systems into a Health Information Exchange, the platform generates a comprehensive, up-to-date profile for every patient. This efficient methodology enhances clinical decision-making and boosts productivity, while also alleviating clinician fatigue by minimizing redundant tasks. Furthermore, the Amadeus DCR incorporates analytical tools and care coordination features, which play a crucial role in promoting improved patient outcomes by detecting risks at an early stage and facilitating effective care throughout the entire patient journey. Ultimately, this integrated system not only optimizes workflow but also fosters a more patient-centered approach in healthcare delivery.

By optimizing and refining the processes involved in human capital management, you can gain complete oversight of costs associated with your workforce and ensure that your valuable human resources are utilized effectively. This allows you to conduct your daily operations with the confidence that your financial, statistical, and accounts receivable data is not only thorough and precise but is also seamlessly compiled and shared with authorized parties with little effort required. With access to a robust suite of integrated and e-commerce-enabled supply chain management software, you can take full command of the entire source-to-settlement process, significantly lowering workload and minimizing errors while enhancing efficiency, ultimately leading to a substantial positive effect on your overall financial performance. This transformative approach not only streamlines operations but also empowers your organization to respond swiftly to changes in the market, ensuring sustained growth and competitiveness.

As a company that emphasizes value-driven healthcare, effective communication through a versatile and scalable platform is essential for your success. NaviNet Open stands out as one of the premier collaboration platforms in the United States, enhancing engagement among providers and producing reliable, actionable insights throughout the healthcare delivery process. This secure multi-payer system not only improves communication but also boosts operational efficiency, reduces expenses, and heightens provider satisfaction. It enables real-time exchanges of crucial administrative, financial, and clinical data between payers and providers. For NantHealth, prioritizing security is paramount. Our adherence to HIPAA regulations, coupled with a steadfast commitment to our core values, has earned us EHNAC HNAP accreditation since 2006. Additionally, NaviNet Open holds HITRUST certification, demonstrating compliance with critical regulations and industry standards. This platform effectively mitigates risks associated with third-party privacy, security, and compliance, ensuring a robust framework for all users. Such dedication to security and efficiency fosters an environment of trust and collaboration in the healthcare ecosystem.

Empower strategic decision-making and foster enhanced collaboration among diverse functions within the healthcare ecosystem. The Incedo™ Healthcare Management Platform presents a robust solution for medical management, seamlessly fusing care management, utilization management, care coordination, and healthcare navigation efforts to boost operational effectiveness and improve patient outcomes. It strengthens communication and teamwork among Care Management, Clinical, and Utilization Management teams by providing a unified view of the member care plan, ensuring a smooth transition between Utilization Management and Care Management. The platform's advanced data capabilities streamline data collection and ensure compliance with CMS regulations through a versatile data repository that can be tailored for detailed data tracking and reporting. Additionally, it promotes system interoperability, enhancing the overall integration within healthcare systems. By implementing this innovative platform, organizations can significantly upgrade their operational processes and patient care quality.

Each record signifies an individual, and every data point holds the potential to significantly impact a person's life, representing an opportunity for understanding and action. Thus, our mission is to foster enhanced health outcomes by refining the management of health information. Over the past four decades, Ciox has played a pivotal role in transforming the healthcare sector through superior health information management and the seamless exchange of health data. Our extensive involvement with medical records spans various industries, empowering us to innovate workflows, enhance access to clinical information, and boost the precision and movement of health data. We assist our clients in safeguarding, organizing, and utilizing health information effectively to achieve improvements in operations, maximize revenue, and ensure better outcomes for patients. Additionally, Ciox HealthSource serves as a fully scalable clinical data platform that harnesses Artificial Intelligence to deliver higher-quality data, alleviate administrative tasks, and enhance financial performance. This integration of technology not only streamlines processes but also sets a new standard for excellence in health information management.

The Care Management Suite represents a comprehensive, data-informed solution for managing care, featuring a suite of tools and processes designed to enhance visibility across the entire spectrum of high-risk and at-risk patient populations. By enabling more efficient and patient-focused workflows, the suite aims to elevate the quality of care delivered while simultaneously lowering overall healthcare costs. Through the use of data analytics, the Care Management Suite identifies areas for improvement throughout the care process, thus driving better clinical, operational, and financial results. This solution is comprised of three key applications: Population Builder™: Stratification Module, Population Care Workflow, and Population Care Insights, each playing a vital role in the care management process. The suite offers a cohesive, end-to-end workflow that encompasses everything from patient enrollment and ongoing care management to patient record-keeping and collaboration among care team members, ultimately saving time and enhancing the standard of care delivered. Additionally, its analytics-driven Data Operating System platform consolidates various claims and electronic medical record data, creating a holistic view of each patient. By leveraging these insights, healthcare providers can make more informed decisions aimed at improving patient outcomes.

HolCare EHR+ is an advanced cloud-based electronic health record system tailored to address the requirements of mental health organizations, telepsychiatry practices, research institutions, and innovative care models. The use of Measurement-Based Care (MBC) has demonstrated significant improvements in patient care, enhanced treatment responses, and better decision-making for clinicians, ultimately leading to improved health outcomes. Nonetheless, the lack of direct integration with an EHR can make MBC implementation difficult and may hinder overall productivity. HolCare EHR+ effectively addresses this issue by incorporating fully integrated MBC, enabling seamless collection of essential measures that enhance patient care. Furthermore, its HL7 FHIR native support facilitates the incorporation of various third-party health technologies. This standardization avoids the pitfalls of costly and time-consuming custom integrations, allowing for a more efficient platform that can exchange both clinical and non-clinical data with collaborative partners, thereby streamlining workflows across the health care ecosystem. Ultimately, HolCare EHR+ empowers organizations to adopt a more holistic approach to patient management and care delivery.

Harnessing the capabilities of Medius’ multi-cloud AI platform enables an impressive accuracy and coverage rate exceeding 90% in health intelligence and risk predictions, utilizing only a handful of health variables. By analyzing a limited set of health data points, Medius’ platform efficiently aggregates and mines extensive datasets to produce vital health risk and underwriting insights in mere seconds, achieving remarkable accuracy and coverage that supports providers and payers in their assessments, operational efficiency, and cost-saving strategies. Furthermore, Medius’ proprietary UW Studio™ serves as a comprehensive underwriting platform that revolutionizes the insurance industry, employing various science-driven underwriting ensemble models to meet both business and technical needs, while emulating human-like actuarial reasoning with clinical precision. This innovative approach not only streamlines decision-making processes but also enhances the overall effectiveness of health insurance operations.

CORTEX represents a groundbreaking advancement in utilization management software, delivering a comprehensive 360° solution to navigate the complexities of utilization management and revenue cycle operations. Powered by an advanced machine learning engine and real-time predictive analytics, CORTEX guarantees that cases are addressed promptly and appropriately, whether by the right personnel or through exceptions. By integrating precision medicine with a robust foundation of evidence-based practices, CORTEX enhances the evaluation of patient populations through real-time machine learning models. Our analytics solutions have been successfully implemented in hospitals and health plans nationwide, demonstrating their effectiveness. For straightforward inpatient cases, CORTEX streamlines the process by automating determinations based on your specific criteria, significantly reducing the burden on staff. In contrast, when facing challenging cases, CORTEX equips your team with critical insights to facilitate well-informed decisions. This innovative approach delivers tremendous benefits to both payers and providers, fostering improved healthcare outcomes and operational efficiency. Furthermore, CORTEX's adaptability allows it to evolve with the changing needs of the healthcare landscape, ensuring sustained value over time.

Forge deep and impactful connections with individuals using a premier digital-first platform. Achieve wellness visit rates that exceed the national average annually. Icario operates as a health action enterprise, meaning you only incur costs based on actual results. By leveraging comprehensive data about the whole person, behavioral insights, and a variety of digital engagement channels, Icario enables you to establish personal connections effectively. We understand individual preferences for interaction and the motivations that inspire them to take health-related actions. As individuals make proactive health choices, healthcare organizations also experience significant improvements. Icario integrates your data with ours to develop a holistic view of individuals, transforming mere data points into real, relatable people. Our unique research on behavior, combined with quantitative analysis, enhances your understanding of individuals from a clinical standpoint to a more personal level. Tailored, smart pathways ensure that the most appropriate messages and outreach strategies are delivered to each person, ultimately encouraging the desired health behaviors. With Icario, you’re not just engaging with data; you’re cultivating relationships that foster better health outcomes for everyone involved.

Transforming fragmented health data into meaningful insights is at the heart of what we do. Clarify Health's analytics platform cuts through the confusion, enabling organizations to excel in a post-pandemic landscape. We provide accurate insights into the performance of healthcare providers, the experiences of patients, and the adoption rates of therapies. With our state-of-the-art analytics software, you can confidently enhance physician performance, align patients with suitable care options, and adeptly manage value-based agreements. Harness insights that can expedite product launches and foster growth, while showcasing real-world effectiveness and facilitating outcomes-based contracts. Accurately pinpoint leading physicians and facilities, offer a more tailored experience to members, and optimize value-based interactions. Our timely insights are generated through a multitude of predictive models, organizing data into real-time analyses that drive measurable return on investment. Fueled by extensive data and cutting-edge technology, we are dedicated to transforming health data into tangible results that make a difference in patient care. In this rapidly evolving healthcare environment, our platform empowers stakeholders to make informed decisions that lead to better health outcomes.

Effective coordination of care, assessment of quality, risk identification, and compliance monitoring are all essential processes that rely on data from a variety of sources and systems, ultimately enhancing the experiences of both patients and providers. Midas Health Analytics offers innovative solutions designed to enhance operational and clinical effectiveness by managing risks, optimizing costs, and transforming data into practical insights. By monitoring and analyzing performance trends over time, organizations can proactively address and reduce risks, make informed decisions in the face of evolving regulations, and create a safe environment for patient care. Achieve unparalleled operational efficiency while assessing, interpreting, and presenting quality of care performance results to stakeholders, navigating the complexities of today's healthcare landscape. This approach not only improves accountability but also fosters a culture of continuous improvement within healthcare organizations.

Numerous patients are in urgent need of your home health services, yet many doctors who could refer them are not doing so. This situation is likely a result of your sales and marketing teams not accessing the 75% of Medicare claims that correspond to office visits. It is essential to showcase your capability to reduce expenses while enhancing patient outcomes. For instance, Home Health Agency A can swiftly illustrate its superior performance over Home Health Agency B concerning hospitalization and readmission statistics. Marketscape for Home Health empowers you to transform your sales and marketing approach, ensuring that you target the most promising physician and facility referral sources. Our innovative technology and dedicated support enable you to efficiently assess your standing against competitors based on various metrics, including hospitalization and readmission rates, diagnostic categories, acuity levels, time to initiate care, overall care costs, and numerous other quality indicators. By leveraging this information, you can strategically align your efforts to maximize referrals and ultimately improve patient care.

We enhance the efficiency of numerous healthcare facilities globally, simultaneously improving the experiences of both staff and patients. Our solution streamlines ambulatory care pathways, providing patients with greater peace of mind. With LGI eClinibase, visibility into patient care pathways is significantly increased, and waiting times are curtailed by sharing detailed information about each care episode. Transitioning from paper to digital allows for rapid access to data regarding referrals, waiting lists, and appointments. Users can generate lists and summaries from multiple clinical administrative systems regarding all episodes of care. The platform facilitates management of referrals, appointments, and patient communications across the entire facility, ensuring a cohesive workflow. Additionally, it offers automatic suggestions to correct patient records and identifies duplicate entries efficiently. Furthermore, it oversees the professional activities agenda, encompassing intake management, appointments, clinical documentation, and statistical reporting for the MSSS, thereby optimizing operational effectiveness throughout the healthcare system.

Our state-of-the-art technology, powered by artificial intelligence (AI), transforms both organized and disorganized healthcare information into a dependable, high-quality, standardized dataset that can be utilized throughout your organization. By facilitating near real-time access to data from various systems, our solutions alleviate the strain of manual data abstraction, enabling your administrative and clinical teams to reclaim valuable time for quality improvement and research endeavors. Our suite of products and services empowers you to gather, assess, and utilize your data effectively, irrespective of the data source, therapeutic area, organizational department, or pre-existing reporting, business intelligence, or analytics tools. Atlas leverages both human knowledge and AI capabilities to streamline the challenging process of uncovering and interpreting patient data for clinical registries. Meanwhile, Cartographer efficiently searches, evaluates, and interprets patient data across multiple platforms, standardizes that information into a uniform format, and offers pertinent data insights. Ultimately, our innovative solutions not only enhance operational efficiency but also support informed decision-making throughout your organization.

CaseTrakker offers a holistic care management solution that guarantees your team has access to the latest information and essential tools for effective member management. Their all-encompassing care management software features a wide array of tools addressing every aspect of health management, including care management and utilization review, among others. With these products, organizations can optimize their core business processes and enhance productivity while maintaining high-quality care management results. Additionally, CaseTrakker portals deliver customized, secure, browser-based access to all CaseTrakker data. These portals create a personalized experience, fostering collaboration among members, providers, clients, and care management teams, accessible from any device, ensuring seamless communication and coordination. This integration of technology not only improves efficiency but also strengthens the overall care management framework.

Acuity Advanced Care™ is a flexible on-premise population health platform tailored to meet the varied requirements of case, utilization, disease, and overall population health management initiatives. This system empowers organizations by granting them complete control over their environment while allowing for customization to cater to each entity's distinctive care strategies. Impressively, over 90% of Acuity Advanced clients hold either NCQA or URAC accreditation, or both. With Acuity Advanced Care, users benefit from the inherent flexibility that an on-premise solution provides, along with comprehensive database access. The on-premise setup enables organizations to dictate the location of their data storage. Those clients who possess skilled IT teams are capable of handling the configuration, security, and upkeep of intricate systems independently. Chordline Health stands out as a premier software provider focused on assisting health plans, TPAs, ACOs, and various risk-bearing entities. The skilled team at Chordline, composed of US-based clinicians and developers, is celebrated for its unparalleled expertise in managed care and exceptional customer service, ensuring that clients receive top-tier support and solutions for their healthcare needs.

TreeAge Pro stands out as the premier software for constructing decision trees, Markov models, and simulations based on events. For over three decades, TreeAge Software, LLC has been at the forefront of decision analysis and health economics. Our dedicated team, consisting of scientists, engineers, trainers, and support staff, has evolved in tandem with the decision analytics community to develop and enhance our flagship product, TreeAge Pro. Based in Williamstown, Massachusetts, TreeAge Software, LLC operates as a privately owned entity. This powerful tool allows users to generate decision trees of any complexity for a variety of decisions. The versatility of TreeAge Pro extends across multiple sectors, including healthcare, legal, oil and gas exploration, management consulting, finance, and education. With a proven track record, TreeAge Software has garnered the confidence of over fifteen thousand modelers across the globe, spanning regions such as the United States, Europe, Latin America, Asia, Australia, and Africa. The software not only facilitates complex analyses but also empowers users to make informed decisions in their respective fields.

By offering a groundbreaking array of solutions and the most integrated care collaboration network available, we are pursuing a holistic approach to healthcare that is transforming expectations and altering the landscape of the industry. This journey toward more informed decision-making and improved outcomes is anchored in a commitment to ongoing dialogue, teamwork, and innovation. This dedication is the cornerstone of our mission, enabling us to achieve significant results across diverse care environments. Empower yourself to choose the best care paths and proceed with confidence, leveraging real-time insights and the nation's most extensive care collaboration network. Efficiently pinpoint the best course of action with streamlined solutions that enhance workflows and accelerate patient treatment. Minimize risks, reduce expenses, and hasten the shift to value-based care through access to previously unavailable proactive intelligence. Bring the concept of whole-person care to life by integrating essential context that encompasses both physical and mental health experiences, ensuring comprehensive support for patients’ well-being. This holistic approach guarantees that every individual receives the tailored care they deserve, addressing all facets of their health journey.

Our innovative virtual therapy and coaching services are designed to alleviate stress, anxiety, and depression, while our accessible self-care resources empower you to cultivate resilience and navigate daily hurdles. By employing evidence-based methods, you will acquire skills to effectively manage your emotions and gain a sense of control in the face of life's challenges. Tailored cognitive behavioral therapy programs, crafted by top mental health experts, ensure that your experience is both personalized and effective. We utilize predictive analytics to identify individuals requiring assistance, thereby enhancing engagement through targeted marketing strategies. With our advanced technology platform, clinicians can optimize costs by aligning members with the most appropriate treatments for their needs. AbleTo’s integration into your health plan’s current care framework is seamless, providing the assurance that you are only charged when our services yield tangible benefits. Additionally, our commitment to continuous improvement ensures that we adapt to your evolving needs over time.

For thirty years, health systems have depended on TeleTracking’s operational platform to effectively manage bed availability and monitor patient progress from initial access through to discharge and into post-acute care settings. TeleTracking fosters comprehensive situational awareness across the system and provides operational insights that simplify processes and enhance efficiency. Our unique methodology, combined with unmatched expertise in patient flow, guarantees that you achieve your long-term objectives while prioritizing the delivery of high-quality care to patients. Ultimately, TeleTracking is dedicated to preserving lives, allowing caregivers to reclaim their time, and ensuring that patients enjoy a favorable experience by facilitating access to the appropriate level of care when and where it is required. Additionally, in light of the financial challenges currently confronting health systems, TeleTracking aids in the enhancement of care delivery without incurring extra costs, requiring additional space, or increasing inventory demands. By integrating innovative solutions, TeleTracking empowers health systems to thrive in a competitive landscape, all while maintaining a steadfast focus on patient-centric care.

Enhance the effectiveness of your organization and streamline the validation process of OASIS data using cloud-based reporting and analytics tools tailored for home health services. By equipping home health agencies with the means to pinpoint actionable insights, you can elevate patient outcomes and star ratings, decrease readmission rates, enhance referral rates, and ultimately boost your revenue streams. OASIS Intelligence serves as the essential platform for addressing your home health agency's needs in performance improvement. Our cloud-based software not only facilitates thorough analysis of organizational performance but also ensures swift and precise validation of OASIS data. With access to the latest data, you can uncover performance trends and identify areas for improvement, leading to quicker enhancements in your processes and increased star ratings. Stay informed about quality standards and reimbursement accuracy through automated notifications that alert you to any errors or discrepancies in the OASIS documentation. Our reporting capabilities are comprehensive and adaptable, allowing you to examine everything from monthly performance trends and condition-specific evaluations to detailed patient-level outcomes. By leveraging these insights, your agency can strategically target areas for growth and improvement, ultimately driving better health outcomes for your patients.

Claims processing can stretch over several months, making it increasingly challenging to control associated costs by that time. A mere few minutes of delay in recognizing patient activity can lead to an unwarranted and expensive hospital admission, which is crucial in the realms of care coordination and achieving success in value-based contracts. MemberMatch delivers these critical insights instantly, equipping care teams with timely intelligence that enables them to proactively and efficiently address active care episodes. This approach assists risk-bearing organizations in enhancing both the quality of care and the financial implications of member interactions throughout the care continuum, ultimately resulting in improved patient outcomes and a healthier financial situation for the organizations accountable for their well-being. By facilitating connections between your care team and the clinical staff involved, essential context can be provided to improve the quality and cost-effectiveness of encounters, helping to prevent unnecessary admissions to out-of-network facilities and redundant testing. In essence, this real-time data empowers healthcare providers to make informed decisions that can significantly benefit both patients and their organizations.

The process we follow for setup is straightforward and efficient. We take the initiative to incorporate our HIPAA-compliant software and services seamlessly into your current workflow. This software is designed to analyze your patient population, pinpointing individuals who might be eligible for Chronic Care Management (CCM) and various preventive programs. Our combination of a dedicated care team and advanced software can handle tasks like enrollment and eligibility verification, patient outreach cycles, and meticulous record management, among other functions. With our integrated approach, we stay closely attuned to the needs of your patients, ensuring timely responses. Our user-friendly, one-click interface provides physicians with essential information about patients requiring urgent care. This is how our system operates: