Solutions.

We deliver solutions for mission critical business processes for the Long Term Services and Supports industry

Assessment Analyzer

Time Tasking Validator

Data Collector

Training Services

 

01  COMPREHENSIVE ASSESSMENT ANALYZER

Complete Clinically Consistent Assessments to Achieve Appropriate Reimbursement

Use of a Comprehensive Assessment in MLTSS provides a full picture of a member across 9 core elements of assessment. Clinical consistency becomes paramount to operating a successful organization. Our solution:

• Uses a proprietary Clinical Suggestions Engine that searches assessments for inconsistency across questions, medications, diagnoses, and the longitudinal member record
• Calculates state-based program Eligibility Logic to ensure member is being authorized for the appropriate services
• Calculates state-based Risk Scores to add transparency to member's risk profile and Estimate Reimbursement
• Monitors Quality Metrics, sets Quality Standards, and identifies At-Risk Members in order to close gaps in care
• Enables management of Assessor Workforce based on Accuracy, Productivity, and Quality of Assessments

 

02  TIME TASKING VALIDATOR

 Ensure Time Tasking Alignment with Clinical Guidelines to Optimize Services Utilization

MLTSS plans need to estimate the type, duration and frequency of services required to meet a members individual care needs and goals. These authorizations are an important part of a individuals care plan and have a large impact of clinical, care management and financial operations of a HCBS organizations. Our solution:

• Uses Clinical Guidelines and Business Rules to trigger Discrepancy Flags for when an individualized assessment is outside the bounds of normal service expectations
• Monitor and Estimate Cost of Services across groupings by Risk Score, Chronic Illness, and levels of Functional Impairment
• Features to manage Assessor Workforce based on Productivity, Quality of Assessment, and Adherence to Business Rules 

 

03  DATA COLLECTOR

Collect Assessment Data and Aggregate in a Cloud Solution to Enable Data Analytics

States have a variety of approaches to assessment data collection that range from paper-based forms to a single digital platform managed by the Department of Health. In order to establish a strong analytical capability, HCBS organizations need reliable data infrastructure. Our solution:

• Provides a Cloud Solution that can accommodate a variety of state-specific assessment question and response data types
• Includes pre-configured questions for Commonly Used Assessments in Long Term Service and Supports Assessments
• A managed database where Data Quality and Data Reliability is monitored and maintained

 

04  TRAINING SERVICES

Receive Tailored Web-based or In-Person Training Sessions to Improve Accuracy of Assessments

Comprehensive Assessments for Long Term Services and Supports have 9 core elements in common regardless of the type of assessment chosen by a State's Department of Health. Our clinical staff provides training on these assessment elements. Examples of Training Sessions include:

• Assessment Approaches, Quality Measures, Comorbidities and Interventions
• Assessment and State-specific guidance on questions
• Quality measurement approaches and calculations
• Review of Case Examples from actual assessments completed by Assessors in session