Applied Research Works Inc, Cozeva has just certified for all NCQA eCQM 2019 measures! Congratulations to our team for getting this done for the second year in a row. This is a huge milestone for our company and another certification under Cozeva’s belt. For more information, please contact email@example.com.
AMP MY2019 Submissions have been completed! Applied Research Works-Cozeva was able to successfully submit for 17 clients and 60 reporting groups this past year and we could not have done it without the essential partnership of our clients. As there were many lessons learned this past season, we will be reflecting on them over the next couple of weeks to make improvements for next year. One client even stated about this past round of AMP submissions: “As Cozeva is a certified NCQA HEDIS engine, the results were unequivocal. If we had a question about the impact reports, we got an answer back right away.” Thank you to everyone who was a part of this year’s submission team and congratulations to all again.
We hope you and your families are staying safe during this unprecedented time. At COZEVA, we are supporting our customers’ workflow and helping them track high risk patients who may require additional care and outreach during this COVID-19 pandemic.
One of the ways of doing this is through COZEVA Analytics to identify your target population. You can slice and dice this data by groups who are at high risk, specific chronic conditions, number of chronic conditions, and recent hospitalizations. You can also track patients you are doing outreach to using the power of COZEVA analytics.
If you have any questions about this workbook or how COZEVA can help during this time, please reach out to firstname.lastname@example.org. Additionally, if there are other workflows that you would like to share, we would love to hear from you!
ARW’s Customer Success Strategy in this time of COVID-19
As COVID-19 has created a new normal with the stay-at-home orders, I sat down virtually with our CTO, Amitava Maulik, and asked him some questions about how our company is continuing to support our clients, our team, and what we have learned from this pandemic.
How do you continue to support your customers during this time?
At ARW, our work transitioned quite smoothly to this new reality. ARW has always taken advantage of software and infrastructure offered as a service. Internally, we already use cloud-based platforms for numerous internal functions from software development, product deployment, sales, employee benefit management, accounting, human resources, marketing, documentation and training. Luckily, ARW’s business and our own platform, Cozeva, has been unhampered just like consumer cloud services most of us use everyday, like Google or Amazon.
How are you maintaining high-performance teamwork?
To help maintain performance, ARW has encouraged its staff to make their home office as private, comfortable and well-equipped as possible. Because we have a distributed team and a flexible work-from-home policy, with remote work and web conferencing firmly established in our workflow, we were able to transition quickly. We also hold daily team huddles and open forum discussions with our teams to ensure that everyone is supported and stays connected. During our weekly All-Hands, different team members are paired up to discuss their ongoing projects and also share their struggles and challenges. Our ongoing challenge is to help our hardworking team members to take enough breaks to keep their bodies moving and healthy while staying safe.
How will this pandemic affect ARW and Cozeva’s development and growth?
Cozeva product architecture decisions when we were first founded, have helped us to weather the pandemic without any hiccups and has avoided many of the challenges of on-premise installed software products. Here are a few ways the pandemic has opened up new opportunities to be of deeper service to our customers:
First, Cozeva helps with proactive outreach to patients most vulnerable to COVID-19. The science is still evolving, but so far the evidence points to underlying comorbidities as potential signifiers that the patient is at higher complication risk if they are exposed to COVID-19. Cozeva has already been helping our customers to run analytics to identify those patient cohorts and conduct proactive outreach and monitoring.
Secondly, Cozeva is helping practices stay productive despite stay-at-home orders. As in-person office visits go to zero, telehealth visits are the new norm because of the need for physical distancing. Many practices have taken this time to close these care gaps via telehealth outreach so that when their offices open up again there will be less of a backlog. Fortunately, because of Cozeva’s cloud infrastructure, doctors and their staff are able to securely login from their homes as needed. This work to catch curable diseases at an early stage or to make sure patients with chronic diseases are trending in the right direction, must still happen even as everyone copes with the isolation of COVID-19.
Finally, Cozeva will be there for the future of COVID-19. When COVID-19 stay-at-home orders are lifted, the virus will still be circulating around the world until a good vaccine is approved a year or more from now and the clinical trials of treatments are final. Cozeva already helps track the annual flu vaccines and we track many comorbidities (smoking, diabetes, heart conditions) that make certain patients more vulnerable to COVID-19 complications. Cozeva will be there to help analyze, stratify and do the best case management for those who need to take extra precaution and get special support. In this time of COVID-19, best-in-class population health is needed by health systems and medical groups more than ever and Cozeva will be there all the way.
Telehealth Risk Adjustment During COVID-19 Pandemic
Can a diagnosis made during a telehealth visit be counted for risk adjustment? That has been the big question surrounding the Risk Adjustment community as our government and top healthcare officials continue to battle COVID-19.
The answer is yes!
From the Department of Health & Human Services on April 10, 2020:
“CMS is stating that Medicare Advantage (MA) organizations and other organizations that submit diagnosis for risk adjusted payment are able to submit diagnosis for risk adjustment that are from telehealth visits when those visits meet all criteria for risk adjustment eligibility, which include being from an allowable inpatient, outpatient, or professional service, and from a face-to-face encounter. This use of diagnosis from telehealth services applies both to submissions to the Risk Adjustment Processing System (RAPS), and those submitted to the Encounter Data System (EDS). In order to report services to the EDS that have been provided via telehealth, use place of service code “02” for telehealth or use the CPT telehealth modifier “95” with any place of service.”
Applied Research Works Announces an Innovative Approach to the Annual Wellness Visit and PAF
FREMONT, CA – February 18, 2020 – Cozeva announced an innovative approach to submitting the Annual Wellness Visit (AWV) and Practitioner Assessment Form (PAF) in Cozeva’s provider portal. The Cozeva AWV and PAF is one form that gives you a robust 360-degree view of each patient all in one location. Cozeva’s AWV and PAF pre-populate data such as CPTII codes, chronic conditions and suspect conditions to reduce data entry burden and ensures HEDIS and HCC gap closures in one visit. The AWV and PAF also suggest codes based on biometric data entered by the provider.
Cozeva’s AWV and PAF form force ranks HCCs alongside the quality care gaps. This allows for a review of suspect HCC related diagnoses codes as well as the recapture of chronic HCC related diagnoses codes. Users can submit the AWV / PAF for review just like any other measure in Cozeva in order to attest to a member’s compliance for the AWV. Conditions must either contain MEAT criteria or be removed before the provider can sign the form. This unique intelligence helps mitigate any RADV audit risk. When reviewing the supplemental data, the provider only gets credit for submitting the AWV once an administrator has reviewed and approved it.
One of Cozeva’s clients, an IPA with over 10,000 Medicare Advantage members submitted 1,987 AWVs in 2018 of which 1,681 patients had any HCC-related diagnosis code. a total of 3,734 HCCs for these 1,681 patients were captured resulting in total RAF at 942.897 or 0.4745 RAF lift per member with an average of $2,278 Per AWV, and an annual ROI of $3.97 million dollars!
Through Cozeva’s AWV and PAF users can easily identify specific under-diagnosed conditions by selective screening, produce audit-resilient documentation and capture data electronically via an 837 or supplemental file all of which helps to automate and centrally track the workflow in the provider office. With Cozeva, there’s only one log-in you need to remember to get the 360-degree view of your patients, submit AWVs, and approve it. Cozeva’s AWV and PAF can provide a major RAF lift for your organization, resulting in a huge return on investment.
Applied Research Works Announces Cozeva Bridge so Providers can Focus on Addressing ‘Real’ Care Gaps
Fremont, CA — February 10, 2020 — Applied Research Works, Inc. (cozeva.com) announced today Cozeva Bridge, a new service in the market that consolidates medical information and incentives from health care provider groups and insurers into a unified view. Cozeva Bridge shares the necessary supplemental information with both health plans and medical systems for payments and reporting. Through the power of Cozeva Bridge, provider groups and insurers are able to access the information in Cozeva’s network and support engaging payment models with standardized and familiar workflows. Cozeva Bridge reconciles and provides Healthcare Effectiveness Data and Information Set (HEDIS®) and chronic condition data capture services to health plans and risk-bearing provider organizations.
Inconsistency and gaps in medical history have become a real pain point for providers, provider groups and insurers. This limited visibility into patient data has caused more headaches for providers, provider groups, and insurers when their priority should be taking care of the patient. As information is exchanged on an ad-hoc basis, information gaps are a major barrier. This causes more paperwork for physicians and less time interacting with their patients. Ironic, since the reason why they became physicians in the first place was to take care of patients. Any additional paperwork to close gaps in information is a challenge with physicians already feeling fatigued from spending twice as much time on paperwork than with patients.
This major headache can now be solved through the power of the Cozeva Bridge. With information and payment consolidation through unified patient and provider views, Cozeva Bridge reduces false alarms from gaps in information and empowers providers, provider groups, and health plans to focus on achieving better patient experiences and outcomes at a lower cost. Cozeva Bridge is a two-way integration between multiple provider groups and insurers that minimizes the administrative burden and complexity associated with sharing supplemental data with different payers. Additionally, a unified view allows both Health plans and provider groups to have visibility into ‘real’ gaps in quality and risk and lets them partner with providers to improve outcomes with better payment models. What can Cozeva Bridge do for your organization?
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.
“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
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.”
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.
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.