Wellcentive: Value-based Reimbursement to Revolutionize Healthcare IT

Kirk Elder, CTO
The healthcare IT industry is going through immense transition that have led to the emergence of many challenges for CIOs who are striving to augment the quality of healthcare offered to patients at lesser cost. The evolution in the healthcare community both from the perspective of commercial payer and care management systems have steered this sector toward value-based reimbursement and disruptive revenue management systems. Therefore, there is a dire need for a unified platform that enables global healthcare enterprises to aggregate data across all their systems and makes it actionable. Additionally, these companies also need a comprehensive data analytics platform that helps understand overall data quality; cut data management cost, and manages the patient information effectively. “The value-based reimbursement requires a whole new set of methodologies to understand risk and incentive contracts,” says Kirk Elder, CTO at Wellcentive. “Also, the industry is plagued with a myriad of complexities around implementing data aggregations, advanced analytics, care management workflows, and collaborating with different IT systems at both strategic and data level,” Mastering the interoperability skills to meet these needs of the present healthcare IT system is the Alpharetta, GA-based Company Wellcentive. The firm has developed a platform that supports the capabilities of multiple systems, reduces integration cost, and performs data aggregation, analysis, and management actions. “Our strategy is to deliver a robust and broad platform that allows our customers to have the agility to meet the quickly evolving value-based payment regulations,” adds Elder.

Wellcentive’s platform includes interfacing, clinical data normalization, data quality evaluation, and self-service applications. “We process about a billion data points, and normalize all of these data points across 200 plus data dictionaries, with 4 million curated clinical mappings,” delineates Elder. The company’s platform caters to the organizations clinically and operationally by leveraging technology. This also helps enterprises to see the financial outcomes—increased ROI, as well as the clinical outcomes. “The Wellcentive platform is entirely physician-friendly and it ensures that the care management workflows abide by the rules of value-based reimbursement,” says Elder.
From an analytics perspective, the platform entails cost and utilization, financial analytics, and clinical quality metrics.

The Wellcentive physician engagement tools engage physicians with Clinical Quality Improvement(CQI) programs in order to successfully improve clinical outcomes and reduce costs

Additionally, Wellcentive’s engagement tools allow physicians and care managers to communicate proactively with the patients through voice andletter outreach, patient report cards, physician alerts, and physician report cards. “Wellcentive’s solutions engage physicians with Clinical Quality Improvement (CQI) programs in order to successfully improve clinical outcomes and reduce costs,” expresses Elder. From the care management perspective, the company has premium content, assessment and surveys, and predictive models. Also they use data science to provide care management recommendations. Ultimately, Wellcentive’s customers are benefitted with increased revenue and an enhanced ability to comply with the rules of value-based reimbursement programs. The company helps enterprises with trans¬formed healthcare IT systems to succeed in the competitive market in the long run.

With over a decade of delivering a population health management platform, Wellcentive has helped customers to achieve extensive profit in value-based revenue by improving outcomes for 30 million patients. The company is constantly investing in maintaining regulatory compliance, care management and provider engagement capabilities and is planning to bring innovative features like suggestive care and automated value discovery to its healthcare IT customers. “We form deep strategic partnerships with healthcare businesses faced with changing revenue requirements to support the iron-going value-based-care operations and maturation,” concludes Elder.


Alpharetta, GA

Kirk Elder, CTO

Delivering comprehensive health management platform for improved value-based care, and increased ROI.