BlueCross BlueShield of South Carolina Implements MedAssurant's Fully Integrated Solution Suite
South Carolina Health Plan engages Data-Driven Approach to Support Focus on Quality Outcomes and Financial Performance
BOWIE, Md. – July 21, 2011 – MedAssurant, Inc., a leading provider of data-driven healthcare solutions, today announced that BlueCross BlueShield of South Carolina will implement MedAssurant’s fully integrated solution suite. With the coordinated launch of seven solution components, the multiyear partnership will focus on quality outcomes, utilization improvement, financial performance and business intelligence across the health plan’s rapidly expanding Medicare Advantage membership.
MedAssurant’s integrated solution suite leverages predictive analytics which are informed by more than 4.5 billion medical events within MedAssurant’s Medical Outcomes for Research on Economics and Effectiveness (MORE2) Registry™ to deliver unprecedented insight and highly targeted resolution interventions. Built on an efficient, common data platform, the solutions are designed to deliver meaningful insight and impact at multiple levels of the care delivery system.
“At BlueCross BlueShield of South Carolina, we are committed to delivering the highest quality healthcare to our membership while effectively managing costs and improving performance,” said Terry Peace, senior vice president, Group & Individual Division, BlueCross BlueShield of South Carolina. “MedAssurant’s integrated solution suite enables us to gain greater insight into areas of improvement, while also partnering with us to drive quality, risk data, and financial performance improvement initiatives across our organization.”
BlueCross BlueShield of South Carolina will implement a suite of seven integrated solutions spanning Star Advantage™, Prospective Advantage™, Capitated Risk Adjustment (CARA™), Claims Aggregation Analysis and Submission (CAAS™), Encounter Data Process Solutions (EDPS), and INDICES™ Business Intelligence. With these tools, BlueCross BlueShield of South Carolina will have end-to-end capabilities to drive highly-informed and coordinated interventions – achieving meaningful benefit to members, providers, and overall health plan performance.
“Adding to the increasing pressures brought by initiatives to understand and improve utilization and quality outcomes, today’s health plans also have increased technology demands brought by the rising complexity in reimbursement models and data submission requirements within CMS,” said Keith Dunleavy, M.D., president and chief executive officer of MedAssurant. “More than ever, the ability to provide an integrated solution to gain an expanded insight and drive coordinated improvements is critical. We are very pleased to join BlueCross BlueShield of South Carolina in their focus to drive improvement as they experience significant growth in membership.”
About the Solutions
Star Advantage™ enables health plans to both better understand and meaningfully improve their CMS 5 Star quality ratings by leveraging the nation’s largest healthcare quality measurement system and a nationwide clinical operations infrastructure designed to provide deep, dynamically updated insight into clinical quality outcomes and highly sophisticated gap closure capabilities – end-to-end.
HEDIS Advantage™ provides NCQA-certified administrative data analytics and coordinated hybrid medical record abstraction and reporting for CMS, NCQA, and state-specific quality programs and requirements.
Prospective Advantage™ utilizes predictive analytics to identify assessment, documentation, and care consideration gaps needing attention to proactively improve on quality, utilization, and risk score accuracy.
CARA™ is the industry’s leading risk score data accuracy improvement solution for risk adjusted Medicare and Medicaid programs.
CAAS™ provides claims data analysis and formatting for submission by risk adjusted healthcare systems.
EDPS provides a comprehensive claims processing and risk adjusted financial valuation solution addressing the CMS transition from RAPS-based submissions to the new 5010 format encounter data submissions.
INDICES™ Business Intelligence platform leverages OLAP cube technology and customized pre-calculated analytics to enable healthcare organizations near-real-time insight into member, provider, and clinical facility care, utilization, quality, disease, demographic, and financial trends and performance.
About BlueCross BlueShield of South Carolina
Headquartered in Columbia, S.C., BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association. The only South Carolina-owned and operated health insurance carrier, BlueCross BlueShield of South Carolina comprises more than 40 companies involved in health insurance services, U.S. DoD health program and Medicare contracts, other insurance and employee benefits services, and a philanthropic foundation that funds programs to improve health care and access to health care for South Carolinians.
About MedAssurant, Inc.
MedAssurant, Inc., is a leading technology-enabled healthcare solutions provider focused on the importance of healthcare data and its ability to drive dramatic, objective improvement in clinical and quality outcomes, care management and financial performance throughout the healthcare community. Proprietary healthcare datasets, aggregation and analysis capabilities, combined with a national infrastructure of leading-edge technology, clinical prowess and deep human resources, empower MedAssurant’s advanced generation of healthcare assessment and improvement through highly informed solutions. Driven by a mission to improve today’s healthcare landscape, the employees of MedAssurant proudly apply care, ingenuity and dedication to delivering a new approach to healthcare touching more than 100 million Americans – one driven by data and insight – one resulting in meaningful action. Please visit www.medassurant.com for more information.
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