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Care Management  


360Care® is a CMS-compliant end-to-end care management solution.  360Care® delivers an intelligent, integrated and proactive approach to improving care management. Powered by sophisticated analytics and smart interfaces that connect disparate data sources, 360Care® seamlessly integrates utilization, case and disease management functionality with predictive modeling, risk scores, profiles and performance dashboards to create participant-centric, actionable information.  It then intelligently presents the relevant information to the appropriate healthcare participants at the right time, driving improved clinical outcomes and care management, as well as enhanced quality measures, compliance and financial performance. The solution set is comprehensive and supported by a best-in-class workflow application that is configurable by the business user.

Key Features:

  • Advanced Technology: Visually intuitive and 100% web-based, 360Care® is HIE ready and ICD-10 compliant and provides stakeholders the flexibility to implement modules individually or all at once.  It is rapidly deployable and can be delivered in a highly secure manner to any device – desktop, handheld and/or PDA.
  • Data Integration: Utilizes prebuilt connectors to collect information from multiple existing systems. Targeted data sets include, but are not limited to, medical claims, pharmacy, laboratory, eligibility, practice management, hospital and EMR.
  • Data Cleansing: Standardizes and optimizes data for use, including participant-specific mapping.
  • Data Aggregation: Uses prebuilt data marts for clinical, quality, operational and financial information to provide visibility to all relevant information and historical decisions in the context of the participant.
  • 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.
  • Utilization Management.  A comprehensive utilization management solution with an intuitive user interface and setup configurable by business user.  Functions supported – precertification, prior authorization, administrative notification, concurrent review and discharge planning. The UM module can be delivered as a standalone.
  • 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
  • Case Management: A comprehensive case management solution. The intelligent workflow queue management optimizes resources used to manage cases, automates the calendaring of tasks and provides the ability to communicate with constituents via the medium of their choice.  Functions include candidate identification, automated assessments, automated care plans, integrated workflow, dashboard reporting, intervention, goals, barriers and outcomes.
  • Disease Management: The DM module provides stakeholders with a disease management solution that is transparent and data-driven, promotes collaboration and has a clearly identifiable ROI. Business user configurable templates for various chronic diseases make an ideal solution for rapid deployment.
  • Health Risk Assessment: Risk assessments can be delivered on a handheld device at the doctor’s office, clinic, or anywhere at any time.  We capture member-supplied health information, which is an important step at improving quality scores. Business user configurable templates for various assessments make an ideal solution for rapid deployment.
  • Risk Scores and Stratifications: MedHOK solutions provide risk measures for every member and enables users to make timely predictions regarding those members at highest risk. MedHOK integrates well-tested and reliable models from a nationally recognized academic institution to generate profiles based on clinical, quality and financial data for members, providers and local populations.  The system uses medical claims and/or pharmacy claims data to create markers of health risk that may indicate a patient’s disease prevalence, severity, and comorbidities; the system more accurately predicts future healthcare costs and pharmaceutical use.
  • 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.