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MedHOK, NYCHSRO/MedReview Enter Strategic Alliance to Provide Health Plans with an End-to-End Solution to Improve HEDIS Scores

MedHOK, NYCHSRO/MedReview Enter Strategic Alliance To Provide Health Plans With An End-to-End Solution To Improve HEDIS Scores

TAMPA, Fla. – Aug. 23, 2011 – MedHOK (www.medhok.com), a leading provider of cloud-based quality, care management and compliance software to the healthcare industry, announced today that it has entered into a strategic alliance with New York County Health Services Review Organization (NYCHSRO)/MedReview. This alliance will provide health plan clients with a comprehensive solution that combines advanced integrated technologies with hands-on chart review to drive measurable improvements in HEDIS® scores.

The relationship will utilize MedHOK’s 360Measures®, which is NCQA-certified for HEDIS, to provide health plans with data aggregation and real-time information tracking and performance monitoring to identify and address gaps in care before they can impact quality and HEDIS scores. Additionally, NYCHSRO/MedReview, a leader in healthcare-related quality and utilization review services for more than 37 years, will provide comprehensive chart reviews. These play an essential role in boosting scores on HEDIS hybrid measures by identifying clinical information not available in claims data.

“NYCHSRO/MedReview is pleased to have the opportunity to form a strategic alliance with MedHOK,” said Joseph Stamm, CEO, NYCHSRO/MedReview (www.medreview.us). “MedHOK’s cutting edge technology combined with our experienced and seasoned Quality Review Services will create the superior HEDIS analytical product on the market today. We become the one-stop shop for health plans, eliminating the need to hire multiple vendors to track HEDIS data and perform chart reviews.”

“Through the innovative combination of MedHOK’s HEDIS-certified software and MedReview’s experienced nursing staff, this alliance will provide health plans with the most comprehensive set of resources available on the market today for monitoring and tracking quality to improve performance and prevent the year-end surprises that plague many payers,” said Anil Kottoor, president and CEO, MedHOK. “We are pleased NYCHSRO/MedReview has chosen to align with us and look forward to a mutually beneficial relationship.”

The strategic alliance delivers to payer organizations an end-to-end solution that improves management of the HEDIS process. This includes:

  • Proactive identification of HEDIS care gaps, which enables clients to notify members and providers of the need to obtain necessary services through multiple pathways and avoid year-end surprises
  • NCQA-certified software for the production of administrative data
  • Production of samples for hybrid measures
  • Expert hybrid chart review, including tracking, project management and integration with administrative data
  • Consulting services to help analyze and define HEDIS improvement targets for all lines of business
  • Real-time target setting and tracking of HEDIS measures for ongoing progress monitoring and performance evaluation

Founded in 1974, NYCHSRO was one of the first organizations registered as a certified Utilization Review (UR) agent in New York. With a diverse client base that includes state and local government entities, managed care organizations, health insurers and third-party payers, NYCHSRO has conducted more than 2 million peer reviews to evaluate clinical decisions and services rendered by medical practitioners.

MedReview is a subsidiary of NYCHSRO, which was established as one of the first physician peer review organizations in the United States. The organization provides clients with guaranteed cost-effective case management and utilization analysis approaches that can assist them in developing or negotiating more cost-efficient benefit plan strategies

About MedHOK

Based in Tampa, Fla., MedHOK (www.medhok.com) offers cloud-based software solutions that eliminate silos and organize client-specific patient/member data into relevant and actionable information that enables physicians, ACOs, PCMHs, payers and TPAs to manage and measure care against national quality standards for optimal outcomes. Information can be shared in real time with all healthcare stakeholders. MedHOK solutions address disease management and care coordination, clinical quality and utilization review, and quality and financial measures. ICD-10 compliant and HIE-ready, MedHOK solutions are web-based, rapidly deployed and securely accessible on any device. The company’s 360Measures holds full 2011 HEDIS® certification.

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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