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Advantmed’s ELEVATE! Quality Insights® Software Is Fully Certified for the HEDIS® MY 2020 Season

Advantmed’s ELEVATE! Quality Insights® Software Is Fully Certified for the HEDIS® MY 2020 Season

Santa Ana, CA – January 15, 2021 – Advantmed, LLC, a healthcare solutions company focused on integrated quality improvement and risk adjustment optimization, has received certification from the National Committee for Quality Assurance (NCQA) for all HEDIS® MY 2020 measures. Advantmed’s hybrid and CAHPS measures were certified in December.

“Certified by NCQA since 2007, Advantmed’s measure logic has been thoroughly tested again this year and is ready to effectively support health plans with the HEDIS MY 2020 reporting season,” says Akash Patel, chief executive officer at Advantmed. “This certification demonstrates the integrity of our software and highlights our focus on providing innovative solutions that enable improved quality outcomes.”

Additionally, Advantmed is working to complete the Integrated Healthcare Association’s (IHA’s) Align. Measure. Perform. (AMP) measure set and anticipates certification later this month. Advantmed’s quality solution suite includes analytics, HEDIS measurement and reporting, medical record retrieval, medical record abstraction, prospective abstraction, virtual and in-home health assessments, member engagement, and provider education.

About Advantmed

Advantmed is a healthcare solutions company dedicated to helping health plans, provider groups, and risk-bearing entities optimize revenue and improve quality outcomes. We offer a suite of integrated solutions, including NCQA-certified HEDIS measure software (certified since 2007), risk analytics, medical record retrieval, abstraction, risk adjustment coding, data validation, and health assessments. www.advantmed.com

About NCQA

NCQA is a private, non-profit organization dedicated to improving healthcare quality. NCQA’s website (www.ncqa.org) contains information to help consumers, employers, and others make more informed healthcare choices.

HEDIS® is a registered trademark of the NCQA.

NCQA Measure Certification is a service mark of NCQA.

Media Contact

Kristin Woodworth

Vice President, Marketing

Mobile: 617.543.8738

kristin.woodworth@advantmed.com

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Advantmed’s ELEVATE! Quality Insights® Software Receives NCQA Certification for HEDIS® MY 2020 Hybrid and CAHPS Measures

Advantmed’s ELEVATE! Quality Insights® Software Receives NCQA Certification for HEDIS® MY 2020 Hybrid and CAHPS Measures

Santa Ana, CA – December 2, 2020 – Advantmed, LLC, a healthcare solutions company focused on integrated quality improvement and risk adjustment optimization, has received certification from the National Committee for Quality Assurance (NCQA) for HEDIS® MY 2020 hybrid and CAHPS measures.

“Health plans and risk-bearing entities use Advantmed’s ELEVATE! Quality Insights solution to support their quality improvement initiatives. Our solution calculates all HEDIS measures, including administrative and systematic hybrid samples for all hybrid-eligible measures in accordance with NCQA’s Technical Specifications,” says Akash Patel, chief executive officer at Advantmed. “NCQA Measure Certification illustrates our ongoing commitment to delivering accurate and reliable results for our clients.”

Currently, Advantmed is working to complete the administrative measures set and anticipates certification in early 2021. Advantmed’s quality solution suite includes analytics, HEDIS measurement and reporting, medical record retrieval, medical record abstraction, supplemental abstraction, virtual and in-home health assessments, member engagement, and provider education.

About Advantmed

Advantmed is a healthcare solutions company dedicated to helping health plans, provider groups, and risk-bearing entities optimize revenue and improve quality outcomes. We offer a suite of integrated solutions, including NCQA-certified HEDIS measure software (certified since 2007), risk analytics, medical record retrieval, abstraction, risk adjustment coding, data validation, and health assessments.

About NCQA

NCQA is a private, non-profit organization dedicated to improving healthcare quality. NCQA’s website (www.ncqa.org) contains information to help consumers, employers, and others make more informed healthcare choices.

HEDIS® is a registered trademark of the NCQA.

NCQA Measure Certification is a service mark of NCQA.

Media Contact:

Kristin Woodworth
Vice President, Marketing
Kristin.woodworth@advantmed.com
617.543.8738

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Advantmed Launches Virtual Wellness Visits to Keep Patients Safe and Healthy

Advantmed Launches Virtual Wellness Visits to Keep Patients Safe and Healthy

Adding telehealth capabilities to its Health Assessment, Advantmed helps clients reach members during the COVID-19 crisis.

Santa Ana, CA – April 9, 2020Advantmed, LLC, a healthcare solutions company focused on risk adjustment and quality improvement, introduces its telehealth solution, which offers virtual, secure wellness visits to patients during the current COVID-19 pandemic.

Advantmed expanded access to its HIPAA-compliant Health Assessment solution by adding an easy to use, secure telehealth application, enabling virtual wellness visits. The virtual wellness visit connects credentialed clinicians with at-risk patients via their smartphone, tablet, or computer. Clinicians check in with patients and conduct a comprehensive health assessment to ensure that they are getting the care they need while keeping them safe at home. Patients easily connect with clinicians from a link in a text message or email without the need for downloads or setup requirements for either providers or patients.

“COVID-19 has changed how we live and how we think about healthcare.At Advantmed, our goal is to improve the cost and quality of healthcare, ensuring patients get the care they need when they need it,” says Akash Patel, chief executive officer at Advantmed. “Telehealth allows us to expand access to quality care for members who need it most. Through our virtual wellness visits, we are checking in on patients, assessing their healthcare status, reconciling medications, making sure that they have what they need, and sharing what health plan and community resources are available to them.”

“Our virtual wellness visits enable health plans and providers to safely check on patients during this challenging time when human connection and safe access to care is more important than ever,” states Patel.

Advantmed’s telehealth solution was developed in response to the Centers for Medicare & Medicaid Services’ recent expansion of telehealth use under the 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act. CMS further clarified its stance on telehealth for Medicare Risk Adjustment in the Federal Register / Vol. 85, No. 66 / Monday, April 6, 2020, confirming the billing codes, place of service, and billing method to support virtual wellness visits.

About Advantmed
Advantmed is a healthcare solutions company providing health plans and risk-bearing entities results-driven, transparent, and innovative solutions that drive clinical and financial performance. We offer a suite of integrated risk adjustment and quality improvement solutions, including virtual wellness visits, health assessments, risk analytics, medical record retrieval, abstraction, risk adjustment coding, NCQA-certified HEDIS® measure software, and data validation. www.advantmed.com

Media Contact:

Kristin Woodworth
Vice President, Marketing
Kristin.woodworth@advantmed.com
617.543.8738

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Advantmed’s ELEVATE! Quality Insights® Software is Fully Certified for the 2020 HEDIS® Season

Advantmed’s ELEVATE! Quality Insights® Software is Fully Certified for the 2020 HEDIS® Season

Santa Ana, CA – March 2, 2020 – Advantmed, LLC, a healthcare solutions company focused on integrated quality improvement and risk adjustment optimization, has received certification from the National Committee for Quality Assurance (NCQA) for all the 2020 Healthcare Effectiveness Data and Information Set (HEDIS®) administrative measures. Advantmed’s hybrid measures were certified in December.

“Advantmed’s measure logic has been certified by NCQA since 2007,” says Akash Patel, chief executive officer at Advantmed. “Once again our measure logic has been thoroughly tested and is ready to effectively support health plans with the 2020 HEDIS® reporting season. This certification illustrates our commitment to providing innovative solutions that enable improved quality outcomes.”

Using Advantmed’s HEDIS® reporting solution, ELEVATE! Quality Insights®, clients can report data and identify service gaps for commercial, Medicare, Medicaid, and ACA health plans. The solution includes simple yet powerful filters for drill-down functionality, as well as provider and member dashboards that provide a 360-degree view into their respective quality scores, measure gaps, and member lists. Advantmed also offers an end-to-end quality services, including medical record retrieval, medical record abstraction, and over-read services.

About Advantmed
Advantmed is a healthcare solutions company dedicated to helping health plans, provider groups, and risk-bearing entities optimize revenue and improve quality outcomes. We offer a suite of integrated solutions, including NCQA-certified HEDIS® measure software, health assessments, risk analytics, medical record retrieval, abstraction, risk adjustment coding, and data validation. www.advantmed.com

About NCQA
NCQA is a private, non-profit organization dedicated to improving healthcare quality. NCQA’s website (www.ncqa.org) contains information to help consumers, employers, and others make more informed healthcare choices.

HEDIS® is a registered trademark of the NCQA.

NCQA Measure Certification is a service mark of NCQA.

Kristin Woodworth
Vice President, Marketing
Kristin.woodworth@advantmed.com
617.543.8738

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Advantmed’s ELEVATE! Quality Insights® Software Receives NCQA Certification for 2020 HEDIS® Hybrid Measures

Advantmed’s ELEVATE! Quality Insights® Software Receives NCQA Certification for 2020 HEDIS® Hybrid Measures

Santa Ana, CA—December 6, 2019—Advantmed, LLC, a healthcare solutions company focused on integrated quality improvement and risk adjustment optimization, received certification from the National Committee for Quality Assurance (NCQA) for 2020 HEDIS® hybrid and CAHPS measures before the December 15, 2019, deadline.

“Advantmed’s Quality Insights solution is used by health plans and risk-bearing entities to calculate all HEDIS® measures, including administrative and systematic hybrid samples for all hybrid-eligible measures in accordance with NCQA’s Technical Specifications,” says Akash Patel, Advantmed’s chief executive officer. “NCQA Measure Certification demonstrates the integrity of Advantmed’s software code and our ability to produce accurate and reliable results.”

Currently, Advantmed is working on completing the administrative measures set and anticipates certification in early 2020. Advantmed’s quality solution suite includes analytics, HEDIS® measurement and reporting, Accountable Care Organization (ACO) measurement and reporting, medical record retrieval, medical record abstraction, supplemental abstraction, prospective health assessments, member engagement and provider education.

About Advantmed
Advantmed is a healthcare solutions company dedicated to helping health plans, provider groups and risk-bearing entities to optimize revenue and improve quality outcomes. We offer a suite of integrated solutions, including NCQA-certified HEDIS® measure software (certified since 2007), risk analytics, medical record retrieval, abstraction, risk adjustment coding, data validation and prospective health assessments. www.advantmed.com.

About NCQANCQA is a private, nonprofit organization dedicated to improving healthcare quality. NCQA’s website (www.ncqa.org) contains information to help consumers, employers and others make more informed healthcare choices.

HEDIS® is a registered trademark of the NCQA.

For all media inquiries, please contact Kristin Woodworth, vice president of marketing, Advantmed, at Kristin.woodworth@advantmed.com or (617) 543-8738.

© 2018 ADVANTMED, LLC. ALL RIGHTS RESERVED.

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Advantmed’s ELEVATE! Quality Insights® Software Receives NCQA Certification for 2019, HEDIS® Hybrid Measures — Weeks Before Deadline

Advantmed’s ELEVATE! Quality Insights® Software Receives NCQA Certification for 2019, HEDIS® Hybrid Measures — Weeks Before Deadline

Santa Ana, CA – November 29, 2018 –  Advantmed, LLC, an integrated risk-adjustment optimization and quality improvement company, received certification from The National Committee for Quality Assurance (NCQA) for 2019 HEDIS® hybrid measures a month before the Dec. 14, 2018, deadline. This certification further validates the Advantmed commitment to improving the health of healthcare, and providing innovative solutions for health plans across the country by helping to improve their measured quality outcomes.

Health plans and risk-bearing entities seeking to improve and/or report on quality measures, rely on Advantmed’s Quality Insights solution,” says Jay Baker, senior vice president. “In addition to timely and accurate HEDIS reporting, Quality Insights supports prospective rate calculation and gap identification. Gap closure services for both risk and quality are also available, giving Advantmed clients a full suite of tools to utilize in their quality improvement efforts.”

NCQA Measure Certificationsm demonstrates to health plans the integrity of Advantmed’s software code and its ability to produce accurate and reliable results. Advantmed is working to complete the administrative measures set, and become a fully certified organization to support reporting of the full HEDIS measure set (which does not include Medicare Health Outcomes Survey or Consumer Assessment of Healthcare Providers and Systems).

Advantmed’s quality solution suite includes analytics, HEDIS measurement and reporting, Accountable Care Organization (ACO) measurement and reporting, medical record retrieval, medical record abstraction, supplemental abstraction, prospective health assessments, member engagement and provider education.

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.

About NCQA
NCQA is a private, non-profit organization dedicated to improving healthcare quality. NCQA’s website (www.ncqa.org) contains information to help consumers, employers and others make more informed healthcare choices.

HEDIS Certified Measures is a service mark of NCQA.
NCQA Measure Certification is a service mark of NCQA.

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Advantmed’s ELEVATE! Software Receives HITRUST CSF Certification, Validates Commitment to Safeguarding Sensitive Information

Advantmed’s ELEVATE! Software Receives HITRUST CSF Certification, Validates Commitment to Safeguarding Sensitive Information

Santa Ana, CA — August 29, 2018Advantmed, LLC, an integrated risk-adjustment optimization and quality improvement company, received the HITRUST CSF Certification from HITRUST Alliance, a not-for-profit organization whose mission is to champion programs that safeguard sensitive information and manage information risk for organizations across all industries and throughout the third-party supply chain. Founded in 2007, HITRUST Alliance collaborates with privacy, information security and risk management leaders from both the public and private sectors to develop, maintain and provide broad access to its widely adopted common risk and compliance management and de-identification frameworks; related assessment and assurance methodologies; and initiatives advancing cyber sharing, analysis, and resilience.

“We are proud that our ELEVATE! solution has been certified by the HITRUST CSF, the most widely-adopted security framework in the U.S healthcare industry, which continues to improve and update its framework ensuring that organizations like Advantmed are prepared when new regulations and security risks are introduced,” says Amit Patel, vice president of technology and compliance, Advantmed.  “This important certification is further validation that Advantmed provides a certifiable framework that provides health plan organizations with a comprehensive, flexible and efficient approach to regulatory compliance and risk management,”

Leveraging nationally and internationally accepted standards including ISO, NIST, PCI, HIPAA, and state laws to ensure a comprehensive set of baseline security controls, HITRUST CSF normalizes these security requirements and provides clarity and consistency, reducing the burden of compliance.

“Advantmed partners with health plans to elevate revenue and quality improvement with services that offer optimal results,” says Patel.

Advantmed’s solution suite includes risk adjustment analytics and coding, medical record retrieval, claims and data validation, HEDIS measurement and reporting, medical record abstraction, prospective health assessments, physician record review, member engagement and provider education.

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.

About HITRUSTHITRUST actively participates in many efforts in government advocacy, community building, and cybersecurity education. For more information, visit www.hitrustalliance.net.

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Advantmed Advances Payer Understanding and Preparation for 2019 Medicare Advantage and Part D Rate Announcement and Call Letter, Issues Fact Sheet

Advantmed Advances Payer Understanding and Preparation for 2019 Medicare Advantage and Part D Rate Announcement and Call Letter, Issues Fact Sheet

Santa Ana, CA — April 12, 2018 — Responding to the recent release of the 2019 Medicare Advantage and Part D Rate Announcement and Call LetterAdvantmed, LLC, an integrated risk-adjustment optimization and quality improvement company, announces the release of its Fact Sheet, highlighting key points to help Medicare Advantage (MA) plans to understand the implications and prepare for these changes.

“MA plan capabilities related to reimbursement, medical cost management, and risk adjustment must be responsive to CMS changes,” says Jay Baker, senior vice president, quality and risk adjustment solutions. “Advantmed recognizes that this is not always a simple undertaking and will lend its expertise to MA plan leaders who can benefit from our experience.”

Highlights from the CMS Call Letter:

  • Finalizing the proposal to calculate risk scores by adding 25 percent of the risk score calculated using diagnoses from encounter data and FFS diagnoses with 75 percent of the risk score calculated with diagnoses from RAPS and FFS diagnoses.
  • Finalizing an updated HCC Risk Adjustment model that incorporates most of the proposed changes to the Part C risk adjustment model, such as adding mental health, substance use disorder, and chronic kidney disease conditions to the risk adjustment model, as well as a variety of additional technical updates.
  • +3.4 percent expected overall YOY change in revenue from Part C Methodology.
  • Expects the underlying coding trend to increase risk scores, on average, by 3.1 percent.
  • Plans to begin implementing the “Payment Condition Count Model” to account for members with multiple conditions in 2020.

“A process should be in place to gather and report encounter data, while quickly troubleshooting submission issues,” Baker adds. “Adjusting to these changes will require specialized expertise because adjustments will impact plan performance, patient care, and compliance. Successful health plans and provider-sponsored organizations must integrate risk-adjustment strategies to meet growing regulatory and market demand for care quality that leads to better patient outcomes.”

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.

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Advantmed Physician Record Reviews: Medicare Advantage Plans Gain Clinical Insights for Risk-Adjusted Conditions and Quality/Care Management Opportunities, Impact HCC Coding & CMS Reimbursement

Advantmed Physician Record Reviews: Medicare Advantage Plans Gain Clinical Insights for Risk-Adjusted Conditions and Quality/Care Management Opportunities, Impact HCC Coding & CMS Reimbursement

Santa Ana, CA — February 14, 2018 — Advantmed, LLC, an integrated risk-adjustment optimization and quality improvement company, today introduces Physician Record Review (PRR), a two-stage retrospective chart review process, first by a certified coder and second with a board-certified physician. This empowers Medicare Advantage (MA) plans with clinical insight into risk adjusting conditions to enhance traditional analytical platforms.

“The ability of physicians to review progress notes for primary care, specialists’ hospital charts, radiology and laboratory results not routinely used in standard analytics provides for more demonstrable actionable information,” says Nilay Shah, president of Provider Solutions, Advantmed. “Additionally, PRR identifies care opportunities in accordance with evidence-based medicine. The Advantmed physician staffs are board-certified in their area of specialty with extensive risk-adjustment training to uncover the potential for risk-adjusting conditions not identified by current programs.”

Shah says that PRRs represent one of the best opportunities to focus on Hierarchical Condition Categories (HCCs), explaining, “Our team of physician reviewers identifies HCCs within each patient chart, annotates risk adjustable conditions by page number, and integrates these outputs into a broader array of activities.”

CMS uses HCCs to reimburse MA plans based upon the health of their members. It pays for the predicted cost expenditures of patients by adjusting those payments based on demographic information, Medicaid status and the severity of illness or patient health status as recorded in medical record documentation.

“Advantmed PRRs also confirm the previous two years of submitted HCCs for clinical confirmation not currently submitted in the calendar year,” says Shah. “The goal is to provide a complete picture for the risk adjustment factor, increasing the accuracy of the patient’s risk score and, ideally, creating clean claims and faster reimbursements.”

Advantmed received certification from The National Committee for Quality Assurance (NCQA) for 2018 HEDIS measures for the 12thconsecutive year. Read more here.

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.