Blue Cross Blue Shield of Michigan Implements Fully-Integrated MedAssurant Solution Suite

SOURCE:  MedAssurant

MedAssurant, Inc., a leading provider of data-driven healthcare solutions, and Blue Cross Blue Shield of Michigan (BCBSM), one of the nation’s top health care plans, today announced an expansion of their partnership to achieve an industry-leading capability to improve delivery of care to its Medicare Advantage members. The partnership centers around integrated quality outcomes, utilization improvement, financial performance, and business intelligence. With a focus on highly coordinated analytics and interventions, BCBSM has partnered with MedAssurant to implement a suite of eight solutions spanning CMS 5 Star Complete Quality Management (CQM™), NCQA HEDIS management, Prospective Advantage™, Capitated Risk Adjustment (CARA™), Claims Aggregation Analysis and Submission (CAAS™), CareSync Advantage™, Business Intelligence, and Distributed Analytics™.

Built upon MedAssurant’s trusted core of healthcare data management and analytics solutions, the integrated suite provides BCBSM with superior capabilities to drive highly informed initiatives focused on quality, utilization, and financial efficiency to improve care to BCBSM’s Medicare Advantage beneficiaries. The data-driven suite leverages predictive analytics 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 into beneficiary and medical provider adherence to guideline-driven care, methods of improvement, and nuances of intervention that enable meaningful results. Going beyond advanced insight, MedAssurant’s solutions provide for end-to-end implementation capabilities to execute in partnership with BCBSM the interventions needed to realize the goals of industry-leading quality, utilization, and financial efficiency – in a fully coordinated fashion.

“At Blue Cross Blue Shield of Michigan, we strive to improve the health of patients across our communities by supporting the highest quality of care and effectively managing costs through innovation and collaboration,” said Mark Owen, BCBSM Vice President of Federal and Individual Business. “MedAssurant’s integrated solutions are powerful resources in our focus on clinical, quality and financial outcomes for the ultimate benefit of the member – while also decreasing the inefficiencies that can occur with disparate systems.”

“The pressure on plans to deliver superior care and enhance their financial performance continues to increase in today’s health care reform environment. Blue Cross Blue Shield of Michigan is an excellent example of an organization with clear focus on these priorities,” stated Keith Dunleavy, M.D., President and Chief Executive Officer of MedAssurant. “The personnel at Blue Cross Blue Shield of Michigan are highly advanced in their understanding of what can drive improvement and efficiency across large health systems. With their partnership, MedAssurant’s integrated systems allow for one coordinated data feed to replace disparate systems, coordinated in-market communication to reduce inefficiencies in care, and integrated analytics to bring the right message to the right member at the right time and place – improving success and minimizing frustration and waste. We are very pleased to be expanding our relationship with this excellent partner.”

The MedAssurant and BCBSM relationship dates back to 2008 when MedAssurant began coordinating clinical data accuracy and claims analytics solutions for BCBSM’s Medicare Advantage lines of business. With this expansion of relationship, MedAssurant will now add Complete Quality Management (CQM™), Prospective Advantage™, Comprehensive HEDIS services, CareSync Advantage™, Distributed Analytics™, and Business Intelligence in a fully integrated platform.

About the Solutions

• MedAssurant’s CQM™ enables health plans to better understand and meaningfully improve their CMS 5 Star ratings by leveraging the nation’s largest healthcare quality measurement system and nationwide clinical operations infrastructure to provide deep, dynamically updated insight into clinical quality outcomes and highly sophisticated gap closure mapping to enable health plans to better understand and meaningfully improve their CMS 5 Star and NCQA HEDIS ratings effectively and efficiently – end-to-end.
• 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.
• MedAssurant’s 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, disease, demographic, and financial trends and performance.
• Distributed Analytics™ provides an industry-leading analytical platform with access to the entirety of a healthcare organization’s data assets, bringing together meaningful data with powerful analytics in an environment friendly to non-technical personnel to enable deep investigation into root cause, improvement, and reporting strategies.
• MedAssurant’s comprehensive HEDIS services provide NCQA-certified administrative data analytics and coordinated hybrid medical record abstraction and reporting for CMS, NCQA, and state-specific quality programs and requirements.
• CareSync Advantage™ enables data-driven coordination between disparate care management and intervention programs so that inefficient overlap is eliminated, individual program performance becomes transparent, inter-program direct referrals are enabled, and member-level detail is appropriately accessible to drive program selection decisions.
• 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.

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