CareSync Advantage®
MedAssurant’s CareSync Advantage solution ensures members are enrolled in the correct care management program at the right time, facilitates seamless referrals between programs, and provides a holistic view of member health. For health plans offering their own (or combinations of multi-party) care management initiatives, MedAssurant provides a custom analytics platform to determine and coordinate member eligibility and enrollment, while also monitoring and reporting on participation and outcomes. The result is a high degree of synchrony between programs; the elimination of overlap, confusion, and waste; and comprehensive reporting on true effectiveness of each program.
Aggregate available member health data
MedAssurant creates a complete member profile by aggregating information from health plan claims, electronic medical records, prescription, lab, emergency room and hospital admission data, and data provided directly by individual physicians and members.
Identify the right care management program to engage members
MedAssurant identifies individuals eligible for care management programs by capturing members known to have the targeted disease, as well as those members for which the clinical picture strongly indicates its presence even without a corresponding claim.
Validate and refer members for the right care
The CareSync Advantage platform facilitates referrals between programs, giving case managers, discharge planners, social workers, and other authorized personnel the ability to submit members for direct referral to a care management program.
Engage members in appropriate care management programs
MedAssurant provides lists of eligible members to each care management program owner. For example, the cancer management program manager receives a list of members in active treatment while the diabetes disease management program manager receives a list of members with diabetes and no other higher acuity conditions. The engagement process is then sequenced according to priority to ensure the delivery of efficient, effective, and appropriate care management efforts.
Inform for action and monitoring
At the population level, clients can see data on eligibility and enrollment, current utilization, risk score, and clinical outcomes. Our clients know precisely the progress, success, quality, and financial impact of each care management initiative at all times.
Improve quality of care with CareSync Advantage
Integrating all available data to create an accurate picture of the member’s health provides the insight needed to engage the right member in the most appropriate care management program. Coordinating all care management efforts across the population of members improves efficiencies, patient satisfaction, return on investment, and quality of care.