How TempDev Helps Payers with NextGen

Insurance and payer affiliated groups such as Optum/UnitedHealth Group(UHG), Anthem, Cigna, & various Medicare Advantage plans have acquired or built strategic partnerships over the past decade with medical groups across the country. Many of these groups utilize NextGen Healthcare electronic health records (EHR) & practice management (EPM) in their clinics. Since the relationship between payers and their partner medical providers often requires unique business needs that aren’t as prevalent at other clients, choosing a consulting services provider who understands this is critical. Our extensive experience and collaboration with these organizations give us the perspective necessary to fulfill these needs.

NextGen EHR Quality Dashboard 

Tracking quality metrics for HEDIS, ACO participation, eCQMs, or other quality programs is crucial to patient care and comprehensive payer relationships. The fastest way to improve quality scores is to have your physicians manage their measures at the point of care. However this can be a complex and difficult task to ask of already overburdened physicians. HEDIS measures, a standard performance improvement tool, cut across six domains of care and comprise over 90-measures, making it extremely challenging to meet all the quality measures and close the care gaps.

Recognizing this issue, the TempDev team partnered with some of the largest ambulatory care groups in the country to develop our NextGen EHR Quality Dashboard. It contains many HEDIS & MIPS measures with annual updates and can be quickly deployed in any NextGen EHR system. The dashboard allows providers to quickly identify gaps in care based on quality measures and take immediate action. 

Many organizations have also decided to pair our NextGen EHR Quality Dashboard template with either Power BI or SSRS reports to improve their quality reporting even further.

NextGen EHR Health Risk Assessment (HRA) Templates, Documents & Reports

HRAs typically are lengthy questionnaires that evaluate a patient’s health status, habits, and potential risks to create recommendations to improve the patient’s care. HRAs are an excellent way for payers to connect patients with the resources they might need to improve their overall health and reduce their risk, which saves costs for the patient and the payer in the long term. Better patient care lowers risk and expense, ultimately creating a symbiotic relationship between patients, physicians, and payers.

Many payer affiliated organizations have created custom HRAs to meet their needs; however, these often aren’t designed in the EHR. TempDev has assisted clients with NextGen template development to create the custom HRA templates in NextGen EHR. Answers to screening questions are captured as discrete data, allowing real-time calculations of patient risks, stratification, and generating a document summarizing the screening in the patient chart. The NextGen development consultants at TempDev have also created custom reports based on HRA physician compliance, scores, and risks.

Patient Stratification & Enrollment Indicators in NextGen EHR

Many payers provide membership rosters, including risk stratification information, to practices that they are partnered with to import into NextGen EHR. The membership information often comes through a direct connection to a data warehouse or flat-file imports. The NextGen conversion team at TempDev works with groups to streamline the import the member rosters into NextGen. They ensure duplicate patients are not entered into the system and develop strategies for helping organizations maintain accurate demographics information on their patients. By importing membership data, you can eliminate staff data entry and ensure correct demographic and payer data is in the system, resulting in faster-processed claims.

Risk stratification being available to physicians while in NextGen EHR is incredibly valuable. Once the rosters are imported, the risk stratification data can be displayed as alerts in NextGen EPM or on templates in NextGen EHR. This data can also be used to drive reporting on which patients in your practice need the most outreach & care.

NextGen EHR Practice Merges & Splits

Payer affiliated organizations frequently perform mergers and acquisitions that often require complex NextGen EHR data conversion projects. TempDev project managers & developers partner with these groups to merge practices together, split a practice into two, and import clinical data from different systems to NextGen EPM and EHR. This helps organizations by ensuring data integrity while allowing for complex business development. Additionally, we provide best practices and ensure all business decisions are made before migrating the information to avoid surprises at the go-live stage. 

Automatically Close the Order Loop with Claims

Since many of the groups associated with payers are managed care organizations, they often have access to claims data that is otherwise primarily unavailable to most organizations. This claim data can help physicians understand when NextGen EHR orders and referrals have been completed, even when they aren’t alerted through traditional mechanisms. This allows for a more accurate closing of the order loop, which improves both patient care and quality scores. TempDev often partners with the data warehouse team to import the claims data through SQL ETLs and close the loop on orders that have been completed. This ultimately saves staff administrative time chasing down results and gets them back to taking care of patients.

Screening Questionnaires in NextGen EHR

Screening questionnaires are a quick way to understand how a patient is doing and often improve quality scores. Some of the questionnaires that TempDev has created as custom NextGen templates include cognitive failure questionnaires, TB questionnaires, depression screenings, and various behavioral health screenings. TempDev can help create custom templates in NextGen EHR for quickly entering any screenings the physicians need. This system takes away the use of paper and allows immediate input of the data as the questions are asked, increasing patient documentation efficiency.

The TempDev Advantage to Helping Payers with NextGen

TemDev helps organizations boost their NextGen Healthcare system with NextGen EHR reportspatient trackingclinical auditsopen orderspractice dashboards, and PAQ audits. TempDev offers tools such as HEDIS Quality Dashboard templates, custom screening questionnaires, and automated integration of data warehouse data to help organizations associated with payers save costs by increasing efficiency and centralizing systems. With our vast experience and knowledge about the health industry, we are the best choice for your organization. Contact us today and acquire custom tailored solutions for your organization. 

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