Dynamic provides an integrated, end-to-end suite of Software-as-a-Service solutions that utilize a centralized database and enables health plans to work with one system and vendor while eliminating departmental silos. “Health plans can mine the rich set of member data from the centralized database and identify gaps in care—improving the quality of care for their members,” says Dynamic’s Chief Executive Officer, Brooks Corbin. The consolidated data simplifies data mining for the health plans and expedites the decision-making process. “Our system applies advanced algorithms against that data to yield actionable results,” states Jim Corbett, Dynamic’s Chief Strategy Officer, and Co-Founder.
Along with facilitating the identification of potential gaps in care, Dynamic’s algorithms also highlight provider coding underperformance, forecast financial data including individual member risk scores, and facilitate the reconciliation of Medicare Advantage Risk Adjustment Processing System (RAPS) and Encounter Data Processing System (EDPS) risk scores. The results can be generated and incorporated into Electronic Medical Record (EMR) systems for presenting to the provider within 24 hours of the patient’s visit. Dynamic’s Hierarchical Condition Category (HCC) Analytics solution identifies discrepancies in the encounter data and the two risk scores, enabling health plans to understand the root cause of issues and quickly address them, resulting in accurate payments from CMS.
Dynamic is able to assimilate disparate data through its proprietary analytics to generate useful findings which empower healthcare organizations
In one of the implementation highlights, a California-based major health system that shares Medicare Advantage risk with several major health plans sought a solution to improve the quality of care and ensure proper risk-based CMS payments. Historically, it used to take around 90 days for the health system to receive information from the health plans related to possible coding challenges and care gaps, and the data was provided in static reports. By adopting Dynamic’s HCC Analytics solution, the health system was able to significantly shorten the timeframe and migrate from static reports to a comprehensive analytics platform.
In its pursuit to help all stakeholders in the healthcare arena, Dynamic also provides an enrollment system for ascertaining every member’s eligibility and enrolling members in Medicare Advantage plans. The system utilizes CMS Batch Eligibility Query (BEQ) process for automating eligibility verification and flagging members with eligibility issues.
Dynamic is currently working on modernizing and advancing the capabilities of its Medicare Advantage solution’s User Interface (UI). “We have subject matter experts for every Medicare Advantage module who collaborate with clients to identify functionality and product enhancements that will be beneficial for them,” states Corbin. “At the end of the day, Dynamic is able to assimilate disparate data through its proprietary analytics to generate useful findings which empower healthcare organizations.”
Dynamic Healthcare Systems News
Acquisition Positions Reveleer as a Leader in Risk Adjustment with Added Capabilities in Enrollment, Suspecting and Targeting Functionality
GLENDALE, Calif. – Reveleer, a leading cloud-based platform empowering data-driven healthcare solutions for health plans and payers, is thrilled to announce the acquisition of Dynamic Healthcare Systems, a company that offers an integrated workflow platform for member management, revenue optimization and risk management solutions.
The acquisition of Dynamic gives Reveleer the ability to round out its existing Risk Adjustment platform with highly valued niche offerings, such as Suspecting and Targeting of high-risk members, HCC Analytics, Risk Adjustment Financial Reconciliation, RAPS / EDPS (Encounter Data Processing) submissions capabilities and member enrollment management. With the integration of Dynamic’s technology into the Reveleer platform, health plans can manage complex Risk Adjustment programs – from enrollment through submissions – on one cloud-based platform for the first time. Reveleer’s Beneficial Intelligence AI automation delivers results faster and with greater accuracy than ever before.
For the past 15 years, Dynamic has been serving health plan customers who participate in Medicare Advantage (Part C/D), Medicare standalone plans (Part D), Medicaid and Exchange programs.
“With the new targeting and suspecting solution in Reveleer, our customers can determine HCC capture, identify risk care gaps for Retrospective and Prospective Risk Adjustment programs, and acquire the data needed for an accurate RAF all in one software platform,” said Jay Ackerman, the CEO of Reveleer. “The acquisition also adds newer capabilities, such as member enrollment, that complement our centralized data lake product, ChartLake, which offers premium member analytics using enterprise-wide member and provider-level clinical data.”
Jay Ackerman added, “We are excited to accelerate our growth with the addition of Dynamic’s proven member data solutions. Reveleer looks forward to partnering with companies that enhance our platform as we continue to deliver on a market-leading payer data analytics solution to our customers.”
Most recently, Moda Health, a multi-faceted organization with a full line of health plans based in Oregon signed with Reveleer for these joint Risk Adjustment solutions.
In addition to Risk Adjustment solutions, Reveleer offers an end-to-end Quality Improvement product that includes full capabilities for data acquisition, Quality review, care gap analysis at the member and provider level, and analytics into provider performance, compliance and Prospective gap capture – all with one software.
To learn more about Reveleer and its services, visit reveleer.com.