Data-enable Provider Networks
How can We Partner with You to Reduce Costs and Enable Faster Turnaround Times?
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Accurately Calculate Risk Adjustment
The reimbursement model in value-based care relies on calculating a Risk Adjustment to determine a provider’s appropriate payment. Providers and Payers exchange medical record data in order to accurately calculate the risk adjustment.
The administrative burden on exchanging data in value-based agreements is expensive to all parties, and there is often a high degree of data latency.
Features & Benefits
Achieve Better Efficiencies
Clinically Integrated Networks (CINs) and Accountable Care Organizations (ACOs) collaborate on caring for populations under value-based contracts, but participating providers are frequently on different EHR systems, especially those in ambulatory settings and physician practices. Due to the multi-EHR environment, the electronic exchange of medical record data is challenging. One method commonly used by ACOs is to normalize payer claim files in order to understand utilization within CINs. While this method is useful, it is a complex task with significant variation in file formats from one payer to the next, and claims data is incomplete and frequently stale—sometimes months old.
The Greenlight solution allows organizations to create Data-enabled CINs and leverage industry standards to achieve better efficiencies. Greenlight refreshes data on a weekly basis which enables a more proactive approach for managing cohorts of patient populations and closing care gaps. Digitization of the medical exchange process creates efficiency, and the data is always current and available on-demand.