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MedHOK’s Technology Platform Positions CMS Comprehensive Primary Care Initiative Participants to Improve Care Coordination, Share in Savings

TAMPA, Fla. – Oct. 3, 2012 – MedHOK, one of the healthcare industry’s fastest growing software companies, announced today that its integrated care, quality and compliance platform positions Comprehensive Primary Care (CPC) initiative participants to improve coordination of care provided under the program. The CPC initiative includes 500 primary care practices representing more than 2,000 primary care physicians and nurse practitioners in seven markets across the country.

Under the CPC initiative, the Centers for Medicare and Medicaid Services (CMS), in conjunction with qualified commercial and state insurance plans, will pay participating practices a care management fee to provide enhanced and better coordinated care to Medicare fee-for-service beneficiaries. This includes ensuring access to care, improving management of high-risk patients, delivering preventive care, engaging patients and care givers, and coordinating care across the healthcare continuum. In addition to the management fee, CPC providers will also share in any savings they generate after two years.

“Much like Accountable Care Organizations, the CPC initiative is a way for physicians and other providers to work together with payers to enhance care coordination, which will ultimately result in improved quality and lower associated costs,” said Anil Kottoor, president and CEO, MedHOK. “Historically, the challenge has been in connecting primary care physicians with specialists to ensure everyone has the information they need to manage patients, particularly those with high risk. MedHOK’s comprehensive platform overcomes these challenges and positions primary care practices to improve coordination and share in potential savings.”

MedHOK offers fully NCQA-certified software for HEDIS®, pay-for-performance (P4P) and disease-management-performance measures. Its comprehensive platform integrates patient information in real time and makes it immediately available to all participants in the healthcare continuum. The disease and case management modules allow primary care physicians to better manage care for high-risk patients, reducing unnecessary utilization and encouraging improved patient self-management. Quality performance modules allow physicians and practice staff to monitor performance in real time and continuously improve quality scores.

MedHOK’s integrated platform facilitates improved clinical outcomes and care coordination while enhancing quality measures, compliance and financial performance. It accomplishes this by:

  • Providing real-time access to Star, HEDIS, P4P, and proprietary quality and performance measures, helping plans and providers to accurately monitor in real-time the data they need to achieve and maintain high-quality ratings
  • Triggering interventions when care gaps are identified, in particular for patients with multiple comorbidities and chronic conditions
  • Utilizing predictive analytics models to generate profiles based on clinical, quality and financial data for member, provider and local populations
  • Calculating risk scores for every member, enabling timely predictions of those at the highest risk and more accurate forecasting of care costs and utilization
  • Continuously monitoring for and addressing regulatory changes from CMS and state Medicaid agencies, ensuring clients stay ahead of the compliance curve

“MedHOK provides primary care practices with the end-to-end solution they need to improve coordination and care and successfully participate in the CPC initiative,” said Kottoor.”Our platform is cost-effective and can be rapidly deployed across the practice, so time and resources can be focused on what’s important—improving patient care and reducing associated costs.”

About MedHOK

Tampa, Fla.-based MedHOK has more than 23 million lives in production and expects to double that number within the next year, making it one of the healthcare industry’s fastest-growing software companies. It offers a cloud-based integrated software platform for care management, quality and compliance that enables physicians, ACOs, PCMHs, payers and TPAs to manage and measure care against national quality standards for optimal outcomes. Its innovative modular software helps healthcare organizations meet quality, care and compliance objectives across business lines by facilitating real-time information sharing with all stakeholders to address disease management and care coordination, clinical quality and utilization review, and quality and financial measures. ICD-10 compliant, HIE-ready and securely accessible on any device, the MedHOK platform is user-friendly, rapidly deployed and easily configurable for a low total cost of ownership and rapid return on investment. It holds 2012 HEDIS®, Pay for Performance and Disease Management performance measures 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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