All Posts by Amitava Maulik

What a Year!

What a Year !

As 2019 comes to a close and we look ahead to 2020, we want to take a moment to reflect on the tremendous year of growth our team has experienced this past year. In the US office, we grew our customer success team as our client list grew to over 20 MSOs and 70 IPAs! This year, we also launched our newest offering, Cozeva Bridge which closes the data gap between health plans and provider organizations.

 

With over 7 million lives loaded into Cozeva, we are grateful for the continued partnership with each of our clients as our client’s success is our success! From our Cozeva Ohana to yours, we wish you all a Happy Holidays and a Happy New Year. See you in 2020! 

 

As a quick housekeeping note, our office will be closed on 12/24, 12/25, 12/31, and 1/1. 

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Cozeva Shines at 2019 IHA Stakeholder’s Meeting

Cozeva Shines at 2019 IHA Stakeholder’s Meeting

“Everything is not impossible.” These were the words from Mick Ebeling’s “Radical Collaboration” keynote address that took both the ARW team and fellow attendees by storm at IHA’s Stakeholders Conference on October 30, 2019. The conference this year celebrated 25 years of IHA and what the next 25 years look like for the association. The big questions that IHA’s President challenged attendees to ask were:

  • How can we improve efficiency through working from a common data infrastructure? 
  • Can we improve measure performance using patient-driven reporting? 
  • How can we achieve encounter data completeness? 
  • What are the lessons learned from the first year of the Symphony Provider Directory as this directory enabled both health plans and Physician Organizations to share provider information according to state and federal requirements to better coordinate care?

During the conference, the Applied Research Works, Inc. (ARW) team not only attended inspiring discussions but also celebrated the following physician organizations who are our Cozeva Champions and Clients that received the following awards at the conference:

2019 Excellence in Healthcare

  • Hill Physicians Medical Group
  • Great Newport Physicians, part of MemorialCare Medical Group
  • Hoag Medical Group
  • MemorialCare Medical Group
  • Mission Heritage Medical Group
  • PIH Health Physicians
  • Premier Healthcare
  • Primary Care Associates Medical Group, part of North American Medical Management
  • St. Joseph’s Heritage Medical Group

Most Improved (Regional)

  • Bay Area: Brown & Toland Physicians
  • Inland Empire: St. Mary’s High Desert Medical Group
  • Orange County: St. Jude Heritage Medical Group

ARW would like to extend a big congratulation to all of our clients who won awards. For the full list of awards, please visit IHA’s website here. As ARW looks ahead, we will take the words of Mick Ebeling with us, “Innovation is driven by always thinking that everything is not impossible.”

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NLP—Just Another Acronym in the Healthcare Alphabet Soup?

NLP—Just Another Acronym in the Healthcare Alphabet Soup?

The Value of NLP Powered Risk Adjustment

Everyone knows Cozeva identifies members with potential suspects and care gaps and presents them to the provider, prompting them to take action. But did you know Cozeva also uses Natural Language Processing (NLP) to read through the structured and unstructured charts, to greatly benefit retrospective chart reviews? NLP is like having another set of eyes (with 20/20 vision) to catch codes the reviewer did not see or pay attention to because they were tired from looking at charts all day. NLP allows for completeness of coding to ensure that you have extracted all the codes documented in the chart, unlocking the most value.

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NLP is not just another acronym in the convoluted healthcare alphabet soup, as a second-level review it leads to a more complete understanding of members’ risk profiles without additional provider contact and abrasion which lessens administrative demands. It also complements existing coding efforts to bring higher confidence in the integrity of the risk adjustment program. NLP helps eliminate any possible upcoding by highlighting the lack of substantiating evidence (MEAT) of a selected condition, mitigating the chance of RAD-V audit. The benefits are not just for the risk adjustment programs, quality teams can pick up data from the chart as well especially when chart chasing prospectively e.g. Annual Wellness Visits which can be customized and completed within Cozeva.

NLP leads to greater accuracy when combined with the manual efforts of the coder and there are many use cases for it. Request a demo to see how Cozeva uses NLP to streamline the compliance & auditing process, manage risk scores, and increase claim accuracy.

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CozevaBridge

CozevaBridge

Focus on Real Gaps in Care

CozevaBridge provides transparency for both the provider groups and health plans to collaboratively close data gaps, so that provider organizations can focus on the real gaps in care.

CozevaBridge Enables TRUST

  • Collate and bridge the two sets of data sources and care gaps (from both provider group and health plan)  to identify and eliminate data gaps for a single source of truth.
  • Enable a single unified set of supplemental data, assessments, and chart uploads

By working on the same platform you can:

  • Relieve administrative burden typically spent on retrieving and consolidating patient information to prove that the quality of care services was rendered 
  • Bolster collaboration between the health plan and provider organization to improve results in risk adjustment and clinical quality (e.g. realtime data sharing, enhanced physician incentive programs, performance monitoring)
  • Distinguish differences between a true care opportunity compared to a data lag or lack of consolidated patient data 
  • Focus on delivering higher quality care to patients, closing care gaps, and treating chronic conditions

Payer-Provider Convergence

  • Ability to label data items (claims, labs, supplemental data) that do not reach provider groups and health plans at the same time as ‘mark as pending’ 
  • Increase transparency between the health plan, provider group, and provider office
  • Improve the quality of care provided to patients through effective care coordination
  • Improve Stars, HEDIS, and RAF scores
  • Decrease provider office frustration and abrasion 
  • Reduce duplicate manual labor and administrative burden

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