Alpha Healthcare’s care management programs supplement — not replace or alter — our client’s model of care through improved data accuracy and participation in interdisciplinary meetings.
Our clients benefit from Alpha Healthcare’s experience with differentiated NCQA-approved payment protocols that optimize performance of specific partners; this is an invaluable resource when submitting Model of Care revisions to CMS.
Our focus on quality enables you to:
- Increase SNF participation,
- Enhance per-beneficiary revenue, and
- Significantly reduce administrative and medical expenses.
You benefit from:
Marketing & Pre-screening
Alpha Healthcare actively promotes the ISNP model, thus attracting more SNFs to participate. We conduct a comprehensive initial assessment of each SNF’s clinical competencies and historical hospitalization profile. This reduces your administrative costs and bypasses providers not ready for ISNP participation, while properly setting expectations/goals for you and the SNF.
Optimized HCC Scores
Alpha Healthcare understands that HCC scores are driven by sources inside and outside the SNF. We help you optimize revenue through a full spectrum of HCC utilization monitoring from physicians to MDS and hospital records, including a detailed historical analysis upon enrollment. Our HCC initiative realized a 17% year-over-year premium increase against the traditional health plan collection process.
“Incubate” Care Management Innovations
You have access to informative and actionable data derived from AlphaTIP (treat in place). This enables you to evaluate the efficacy of new models without the time, expense and risk associated with such initiatives. Based on these insights, you can re-create successful models independent from us.
Improve Physician Data to Support the Model of Care & Reduce Administrative Costs
While most Medicare Advantage plans manage physician encounter data on a claim basis, Alpha Healthcare helps clients design, implement and support a capitated physician reimbursement model predicated on accurate encounter data. We help you reduce administrative costs and simplify payment by transforming a traditional payment convention into robust documentation that supports the Model of Care. By removing the urgency of claim processing, we can dissect encounter data and improve detail that compliantly optimizes HCC scores.