Patient Centered Medical Homes  

Medicaid and Medicare are embracing patient-centered medical homes (PCMHs), in which primary-care physicians take an active role in monitoring the utilization and quality of services provided to patients.  MedHOK’s software provides you with the infrastructure you need to manage patients and coordinate care for these individuals through specialized workflow management tools.  Our software helps you be successful by allowing you to monitor your financial and quality performance to ensure eligibility for bonuses and other incentives tied to your practice.

MedHOK Solutions are 100% web-based, leveraging cloud computing for scalability. Further, they are HIE ready, and ICD10, 5010 and HIPAA complaint. We have designed our solutions as separate modules working together using consistent standards, tools and technologies. This gives our stakeholders the flexibility to implement modules one at a time or all at once. Our modules include:

• Connectivity: HIE ready and NHIN compliant.  We create a private PCMH HIE and connect all participants in the ecosystem to share actionable and relevant information.
• Data Integration: Collect data from multiple, existing systems using prebuilt connectors, including administrative, clinical, quality, survey, EMR and financial information.
• Data Aggregation and Cleansing: Cleanses, normalizes, standardizes and optimizes data to make it actionable.
• Data Marts: Prebuilt clinical, quality, financial and operational data marts and configurable templates radically reduce design and setup of custom measures.
• Provider Contact Management: Ability to track all the correspondence and contacts between providers, patients and the PCMH.
• Evaluate disease and care management programs: Enables detailed assessments of client programs, including actionable insights that help medical directors make informed decisions to improve program performance.
• Metrics dashboard: Provides ongoing status snapshots, including a tailored set of performance metrics, to measure current program performance against multiple baselines, including historical performance and external benchmarks.
• Early detection of uncoordinated care: Identify patients or populations with uncoordinated care patterns to facilitate early interventions that can lead to improved quality and satisfaction scores.
• Quality Measures Management: MedHOK software helps boost HEDIS, non-HEDIS and CAHPS measures and provides proactive monitoring and identifies gaps to help improve Star and other quality metrics. MedHOK provides all constituents with an unprecedented ability to proactively design, monitor and share quality and performance data delivered via intuitive tracking tools and dashboard reporting. Learn more
  
• Care Management: Health plans can improve patient health by targeting the right members at the right time with the right interventions across the entire health continuum.  Capabilities  include:
  • Business Configurable Workflow: User-configurable templates for various assessments make an ideal solution for rapid deployment.
  • Utilization Management: Functions supported – precertification, prior authorization, administrative notification, concurrent review, discharge planning. The UM module can be delivered as a standalone.
  • Case Management: Functions include candidate identification, automated assessments, automated care plans, integrated workflow, dashboard reporting, intervention, goals and outcomes.
  • Disease Management: Business user-configurable templates for various chronic diseases make an ideal solution for rapid deployment.
  • Risk Scores and Stratifications: Identify risk scores and stratify high-risk, high-cost patients.   Learn more
    
• Appeals and Grievances: MedHOK provides a business-configurable, workflow solution for processing and tracking appeals and grievances. The system offers a structured workflow based on individual user roles with responsibilities/functions that define which tasks can be completed by the specific user. The system-defined workflow ensures that cases are processed consistently and correspondence is triggered automatically and attached to the original case. Learn more