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MedHOK Acquires Continuum Performance Systems

MedHOK Acquires Continuum Performance Systems

With its acquisition of CPS’s Market Prominence™ suite, MedHOK is the leading compliance software platform for government-sponsored programs

TAMPA, Fla. – April 28, 2015 – MedHOK™, Inc.’s 25th fastest-growing private company, solidified its position as the leading compliance software platform for government-sponsored health programs with its acquisition of Continuum Performance Systems, Inc. (CPS). The deal allows MedHOK and CPS to offer health plans, pharmacy benefit managers (PBMs), and other risk-bearing entities an end-to-end software platform to manage compliance across enrollment, clinical, appeals, grievances and complaints for improved medical and pharmacy quality outcomes.
The MedHOK compliance software platform includes medical and pharmacy prior authorization and appeals, grievance and complaint management, risk stratification and case and disease management, as well as Rx specialty management and medication therapy management (MTM) solutions. It also includes solutions to address HEDIS®, care gaps and Star quality performance issues.

With the addition of CPS’s Market Prominence™ suite of products, the combined companies can now offer crucial compliance solutions for sales processing and management, plan enrollment processing and management and Centers for Medicare and Medicaid Services (CMS) enrollment submission and processing, as well as premium billing, member services, and Medicare and plan financial reconciliation.

Market Prominence specializes in compliant processing of Medicare enrollment and supports Medicaid and commercial/Exchange lines of business.

Both companies’ solutions are pre-configured with state and federal rules and processes to mitigate risk and ensure audit compliance. With the addition of CPS’s product suite, MedHOK furthers its industry- leading approach to ensuring compliance with state and federal regulations, reducing costs, and improving quality outcomes in a health care industry that is increasingly focused on value-based payments.

Since its founding in 2010, MedHOK has achieved numerous milestones, including:

  • Being named the 25th fastest-growing private company and the 6th fastest-growing private health care company in 2014 by Inc. magazine
  • Adding as clients several of the nation’s largest health plans, including prominent Blue Cross and Blue Shield and market-leading regional plans and pharmacy benefits managers (PBMs)
  • Expanding its customer base to include more than 50 of the nation’s largest healthcare companies
  • Managing the nation’s largest number of Medicare and Medicaid lives on its software platform CPS is based in Madison, Conn., with a major presence in Cheraw, S.C. Tampa-based MedHOK plans to continue to invest in all three states as part of the acquisition.

“CPS clients will realize immediate value from this acquisition, which gives them access to the industry’s leading single platform for care, quality and compliance,” said CPS Founder Brad Turley. “Our team looks forward to working with the MedHOK team to ensure a smooth transition and continued growth for both companies.”

“This acquisition brings together two highly complementary platforms, strengthening our ability to meet the evolving compliance and clinical management needs of government-sponsored health plans and other risk-bearing entities,” said Anil Kottoor, president and CEO, MedHOK. “By combining our individual strengths we are addressing the need for transparency and real-time access to a complete patient profile at every touch point. The combined companies provide the essential tools needed to succeed as federal and state governments continue to build the new healthcare accountability model.”

Marc Ryan

Marc S. Ryan serves as MedHOK’s Chief Strategy and Compliance Officer. During his career, Marc has served a number of health plans in executive-level regulatory, compliance, business development, and operations roles. He has launched and operated plans with Medicare, Medicaid, Commercial and Exchange lines of business. Marc was the Secretary of Policy and Management and State Budget Director of Connecticut, where he oversaw all aspects of state budgeting and management. In this role, Marc created the state’s Medicaid and SCHIP managed care programs and oversaw its state employee and retiree health plans. He also created the state’s long-term care continuum program. Marc was nominated by then HHS Secretary Tommy Thompson to serve on a panel of state program experts to advise CMS on aspects of Medicare Part D implementation. He also was nominated by Florida’s Medicaid Secretary to serve on the state’s Medicaid Reform advisory panel.

Marc graduated cum laude from the Edmund A. Walsh School of Foreign Service at Georgetown University with a Bachelor of Science in Foreign Service. He received a Master of Public Administration, specializing in local government management and managed healthcare, from the University of New Haven. He was inducted into Sigma Beta Delta, a national honor society for business, management, and administration.

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