Provider and Provider Groups

Provider Portal Module

Health plans are increasingly focused on avoiding administrative waste and promoting quality patient health outcomes. Health plans and providers needed real-time visibility to monitor and manage risk adjustment revenue against budgeted gap closures and key performance indicators (KPIs)

 

The Invent Health provider portal enables health plans and provider groups to work collaboratively, achieving precise risk adjustment analytics to manage Medicaid, the Affordable Care Act (ACA), and commercial and Medicare Advantage markets.

 

The MAP leverages aggregated data from various sources (claims, AWE, quality measures, clinical data)  in a sophisticated manner in order to gain a more complete understanding of members’ health, increase the ability to carry out targeted interventions and obtain a greater ROI. Provider 360 effectively enables providers to prioritize patients and identify open care gaps for proactive closure at the point of care support visibility to manage current, projected and suspected conditions.

Quality Reporting

Risk Adjustment

Financial Reconciliation

Provider Management

Care Coordination

Provider Portal Features

Invent Health Provider 360° approach considers risk adjustment optimization, including how to stratify membership for gap closures, enhance provider collaboration, integrate with multiple departments (risk and quality), and obtain performance control and transparency.

Near real-time visibility to key performance indicators (KPIs) like HCC capture rates and potential revenue opportunities

Displays a population-level view of gap closure opportunities, detailing which gaps have been confirmed and which gaps remain open.

Prioritizes all possible gap closure opportunities, recommends optimal intervention strategies to close the care gaps in an optimal manner through concurrent.

Provides detailed data analytics empowering healthcare providers to monitor HCC risk scores, track quality metrics, and care gaps that require intervention in optimized manner.

Provider Portal Benefits

With the executive and Provider 360 views, MAP prioritizes actionable data for leadership and breaking down departmental silos to set up a foundation for performance improvement.

For incentives, education, and tools to increase providers’ engagement with payer-led initiatives.

In provider engagement, member outreach, and data-driven prioritization for risk score gaps and quality score improvements.

Ensure maximum adherence to regulations and protect against possible audits and penalties.

Compared to their peers by taking a comprehensive approach to risk adjustment and risk-based programs.

Provider partners are equipped to deliver the right care to the right patients at the right time.

Create role-based workflows and custom KPI templates per line of business across risk, utilization and quality

Provider Portal (PPGs / IPAs)

Web-based provider portal exclusively for provider practice groups PPGs / IPAs

Provider Opportunity Report

Web-based provider portal exclusively for provider practice groups PPGs / IPAs

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