Advalent Population Health Manager: Data Driven Clinical Insights
Single Sign-on Intelligence platform supporting Big Data integration, Risk Stratification, Analytics, Reporting and Provider Profiling

With the focus on identifying high-risk and emerging high-risk members that are likely to yield most return (clinical and financial) with clinical intervention, Advalent’s population health manager offers risk stratification, utilization focused analytics and reporting, quality of care and provider profiling solutions. The prospective clinical and financial risk is quantified using Milliman MARA risk score, which is one of the many member-related attributes used to stratify members for identification of target cohorts for clinical intervention.


Patient passport – 360-member view

With clinical information integrated from varied sources, Advalent patient-passport contains all the clinically relevant information concisely presented to the care team members. The alerts from care gaps, biometrics, HRAs, drug-interactions, and recent high cost events, like admission, and ER are all present in the patient passport. The goal is to provide a holistic picture of all the clinically important information to the care team members.


Proactively closing open care gaps

Advalent identifies care gaps based on NQF-endorsed measures, NCQA HEDIS® and P4P, ACO 33, Star measures and others driven from evidence-based guidelines. The care rules can be customized to meet the exact client needs, and users can drill down into member level details for holistic clinical views. Actionable care rules are integrated into the daily workflow of nurse navigators as triggers and alerts that appear on the care team members’ calendar.


Health Risk Assessments (HRAs)

Our clinical platform captures self-reported clinical and social information on members in the form of HRAs and uses them to drive our risk stratification and care management solution. They are integral to augment the clinical information from standard sources like medical and Rx claims, helping us identifying missed opportunities, and to evaluate effectiveness of health programs. Our HRA forms are very user friendly and intuitive.

Single-sign on Platform

  1. Single sign-on platform for population, care management and utilization management, integrated with third parties, like Milliman MARA risk scores, MCG CareWebQI utilization management and NCQA HEDIS® measures
  2. Personalized care plan and monitoring of open care gaps
  3.  Patient passport – single platform to give a 360-degree view of members’ clinical information and cost
  4.  Personalizing delivery of care designed specifically meeting individual needs and preferences
  5. Standardized communication between hospital EMR to outpatient and office locations, and among care team members (nurses, therapists, physicians) using HL-7 messages
  6. Tracking the impact of closing the clinical gaps in care, and changes in inpatient, emergency, outpatient, professional, and pharmacy utilization and costs.

Big Data Population Health Analytics

  1. Health Risk Assessments (HRAs) to consider self-reported member health information to verify or modify claims based analytics and reporting
  2. Outcome measures to accurately measure return on investment to enable timely intervention
  3. Health Plan design optimization
  4. Healthcare cost management
  5. Performance dashboards, Care team activity log, reports with heat map
  6. Focus on both cost and quality with emphasis on preventive care and chronic disease management.

Actionable Intelligence and Analytics

  1. Up-to-date analytics and reports based on clinical information from medical and pharmacy claims, HRA, HER and from facility systems like HL-7, utilizing diagnosis, procedures, drugs, LOINC, DRG, place of services and other industry standard codes.
  2. Customizable single-sign on intelligence platform to leverage various reporting options and client needs.
  3. Trends in cost and quality of care, dynamic real time processing as needed on intervention-targeted cohorts.
  4. Longitudinal data analysis from our patient-centric solution presents an intervention focused and outcome oriented information for the care provider to look at, minutes before talking to the patient
  5. Clinical and Financial Risk stratification using predictive algorithms, clinical rules
  6. Actionable intelligence / Value based analytics utilizing clinical and financial data.