Power and scale your value‑based initiatives

Unify your clinical and financial data to deliver better care at a lower cost.

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Value-Based Care

Data silos and disparate systems are the barriers to transitioning from healthcare volume to healthcare value. In order to bend the cost curve and provide better quality care at a lower cost, health plans, ACOs and government agencies must turn siloed data into actionable intelligence. Healthcare value success requires the implementation of an innovative formula spanning three critical areas: clinical data integration, population monitoring, and the administration of risk-based programs and contracts.

Our Solutions

Edifecs Value-Based Care is a single integration point for clinical, financial and administrative information received from disparate sources. The solution unifies end-to-end program management, identification of at-risk populations and evidence-based interventions to align program goals with care delivery operations.

Our approach delivers a turn-key solution to remove volume to value barriers by turning traditionally siloed data into usable intelligence for the entire enterprise.

Intervention Gateway and Population Dimensions

  • Exchange administrative and clinical data and support patient adherence to care programs.
  • Connect and enhance interactions to increase data quality and compliance.
  • Offer secure, role-based access to time-based views of integrated healthcare events for care providers.
  • Transform healthcare data into actionable clinical intelligence to deliver near real-time insights for healthcare partners to jointly manage their shared populations.
  • Sharpens the care team’s ability to dynamically detect care gaps for patients who are monitored in population health and accountable care programs.

Intervention Gateway | Population Dimensions

Population Payment Management

  • Identify, align, and attribute appropriate provider and member rosters according to historical risk and cost stratification.
  • Deliver value-based contract baseline and impact modeling, with ability to preview attribution, risk, and budgets, including “what if” analyses.
  • Increase the adoption of Alternative Payment Models (APMs) among participating providers and payers by increasing visibility and alignment with financial and quality measures.
  • Deliver a robust and highly scalable platform that enables bringing pilot projects to enterprise and community level.
  • Provide business intelligence and reporting tools including dashboards and reports with drill-down capability with role based access.

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Who We Help

Health Plans

Edifecs enables health plans to ingest clinical data and implement a platform designed to initiate, monitor and scale value-based initiatives such as shared savings, bundled payment and P4P programs.

ACOs

We assist entities involved in ACO programs (CMS, health plans and providers) by integrating claims and clinical data to reveal actionable insights for closing care gaps, refining intervention strategies, improving care team coordination, and greatly enhancing the ability to meet value-based financial and performance targets.

Government Agencies

We provide CMS and state Medicaid agencies the ability to scale value-based care initiatives and accelerate quality payment programs. Our flexible infrastructure streamlines compliance to new rule changes.