Quality Support Solutions
Centauri helps Medicare Advantage and Commercial health plans achieve optimal performance and gain a competitive advantage in their HEDIS® and Star Ratings programs through our quality support solutions.
Current requirements call for payors to retrieve and transmit clinical information about their members to providers in their network. For example, primary care providers (PCPs) must be notified of their patient's discharge within 48 hours after emergency room visits for patients with two or more chronic conditions and assess the rate of unplanned acute readmission after discharge.
Exchanging clinical information for quality programs and value-based care has always been a labor-intensive, manual process resulting in missed care opportunities, unnecessary costs, and friction between payors and providers. Centauri replaces costly, manual workflows with standards-based connectivity and data formats that eliminate provider abrasion, optimize cost, and effectively leverage data. Our workflow optimization expertise translates into higher scores, better reimbursements, and more incentives to health plans.
- Leverages established flows for monitoring admission/discharge data, querying for patient charts and integrating into the health plan enterprise systems
- Delivers data seamlessly into current provider workflows
- Results in no provider abrasion
- Aligns with enterprise interoperability goals
Streamline Data Retrieval Workflows
Our demonstrated experience in the clinical data exchange space enables us to support complex high-value use cases and bi-directional exchange. Additionally, our nationwide alerting and chart retrieval network uniquely positions us to assist healthcare entities with new Star and HEDIS requirements.
- Electronic capture of the medical record data from a provider's electronic medical record (EMR) system or an aggregator partner (HIE/HIOs).
- Using a variety of connectivity mechanisms to send C-CDA’s to a health plan’s secure endpoint and deliver normalized (CCD) and free-form information to each EMR system.
- Leveraging existing ADT member monitoring and using discharge data as the triggering event to request a patient chart from existing data source partners.