Care Delivery Organizations

///Care Delivery Organizations
Care Delivery Organizations2018-03-03T13:31:11-06:00

Integrated Delivery Systems

The transition to Value Based Care has raised new challenges and opportunities for provider-based organizations. Evolving reimbursement and care delivery models has increased the need to improve financial and clinical outcomes. Care Delivery Organizations must better manage population health and individual patient care paths.

EMRs were designed to support episodic clinical care and are ill equipped to manage longitudinal Care Management or integration with payer systems. Essette provides a consolidated patient-centric view and supports Coordinated Clinical Care with a seamless integration into practice workflow.

We are extremely proud of our rising status among clients with unique business models—including those represented by provider-based organizations.

Supporting Interdisciplinary Teams for Coordinated Patient-Centric Care

  • Supports embedded or centralized Care Management Models
  • Automated care plans individualized for each patient
  • Wide range of options for Evidence-Based Content
3600 view including demographics, claims, auths, Dx, Rx, Labs, etc.
  • Eligibility/Benefits Verification
  • Rule based Auto-adjudication
  • Tightly integrated evidence-based guidelines
  • Upload supporting documentation for authorizations and care management
  • Route tasks to members of ICT
  • Support multi-channel communication with patients to close gaps in care
  • Combine and analyze data from multiple sources: EMR, Claims, etc…
  • Apply analytics with a comprehensive campaign designer to engage patients in wellness & health promotion programs

Learn more about HMS Essette software features.

– Organize patients by panel, practice, ACO, etc…
– Share Case Summary with care team, which includes all assessments and Care Plans.
– Role based workflow allowing interdisciplinary teams to interact with assigned Goals, Interventions and Tasks.
– Document notes.
– Create and view personalized patient correspondence.
– Review patient’s Problem List to tailor care plan.
– Users across the health system can upload and share documents.
– Submit an auth or referral all on the same platform.
– Document and manage CCM services, Annual Wellness Visits, etc. to optimize reimbursement from CMS and other payers.

HMS Essette brings together information from a wide variety of sources, and makes that information available to coordinated care teams in ways that cannot be accomplished in legacy EMR, Registration, or Billing systems. We have years of experience integrating with clinical and financial systems—eliminating dual data entry and providing a complete 360 degree patient view of all information needed to provide truly coordinated care.

HMS Essette Integration can support virtually all industry interoperability standards:

– HL7 transactions for ADT, CCD/CDR exchange and other clinical data import
– ANSI X-12 HIPAA EDI transactions for auth, eligibility and claim detail
– Direct SQL Server and flat file imports
– HMS Essette published and 3rd party APIs for direct application communication

Supports personalized communications to patients and all members of the care team utilizing multiple channels including Mail, e-mail, Portal, SMS, IVR…

Securely exchange HIPAA-compliant documentation:
– Clinical: Care Management, Authorizations, Referrals and Population Health Management
– Operational: Provider Relations, Claims, A&G and EOBs
– Business: Contracting, Network Management, Risk Management

Eliminate problems with manual delivery, lost paperwork, poor legibility, and delays associated with faxing and scanning.

A Unique Alternative

HMS Essette offers a robust highly customizable alternative to ‘shrink wrapped’ applications. Our web-based solutions help users streamline workflow, comply with regulatory requirements, and most importantly, improve patient care outcomes.

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