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AdvantmedPressAdvantmed Introduces Prospective Health Assessment Services, Provides Health Payers with Actionable Insights into Member Health Status

Advantmed Introduces Prospective Health Assessment Services, Provides Health Payers with Actionable Insights into Member Health Status

23 January 2018

Santa Ana, CA — January 23, 2018Advantmed, LLC, an integrated risk-adjustment optimization and quality improvement company, today introduces Prospective Health Assessments (PHAs), empowering health plans, provider groups and risk-bearing entities with actionable 360-degree insights into the health status of member populations. PHAs provide an effective tool for facilitating timely gap closure and improving care management initiatives. PHAs can occur at any time during the year and can be scheduled for Medicare Advantage (MA), Commercial and Medicaid members that have been non-adherent in scheduling primary care appointments.

Nilay Shah, president of Provider Solutions, says, “Advantmed’s PHAs focus on identifying new conditions, re-capturing and documenting previous chronic conditions, and closing quality care gaps.  They provide real-time visibility into assessments and documentation, integrating analytics, physician chart reviews and evidence-based screenings to drive higher engagement rates and optimal results.”

Members have the flexibility of having the assessment conducted by Advantmed’s highly-trained nurse practitioners in their home, in a centralized Advantmed clinic or in a primary care physician’s office. Advantmed clients receive:

  • Patient acceptance rate for in-home visits of greater than 35 percent
  • 100 percent electronic (tablet-based) assessments
  • 100 percent quality audits of all assessments
  • An average revenue increase from $620 to over $1,500 per assessment

Advantmed integrates quality measures, including Star measures, HEDIS® and CAHPS®/HOS. The proprietary process involves a comprehensive assessment that focuses on member engagement and clinical profiles to gather the most accurate data.

The ELEVATE! platform allows clients to view project dashboards and drill-down options, including call metrics and detailed call comments, status on non-cooperating members and reason codes.  All clinical data and HCCs are hyperlinked within the assessment.

Shah adds, “This PHA offering further expands our exceptional portfolio of services, and extends our commitment to enhancing financial, clinical and operational outcomes for MA plans and their members.”


About Advantmed, LLC
Advantmed, LLC is a healthcare solutions company dedicated to partnering with health plans, provider groups and risk-bearing entities to optimize risk adjustment and quality improvement programs.  Our integrated and technology-enabled solutions improve health plan financial results and offer insights on health plan members.  For more information on Advantmed’s solutions visit www.advantmed.com.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

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