Health Plan Solutions


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Health Plan Solutions Overview


No One Moves the Needle Like Medical Advantage Group

Health plans have much at stake in today’s value-based care market. A plan’s success in value-based care is largely dependent on physicians and other health care providers to deliver the results they desire.

Medical Advantage Group is uniquely positioned as a bridge between health plans and providers. On behalf of health plans, Medical Advantage Group maximizes provider performance by improving clinical and financial performance at the point of care.

Through our hands-on partnership, we educate and train practice teams on how to make small changes to their operations for higher performance in value-based contracting. Our solution allows providers to continue to focus on care delivery while we re-engineer the practice to ensure both providers and plans get the data they need to optimize performance on quality metrics, risk adjustment programs, and medical loss ratios – a win for both providers and health plans.



As value-based care contracting arrangements continue to expand, health plans and physician practices are becoming increasingly dependent upon each other for survival.

Hands-on help in the practice is the key to transformation that improves quality, manages cost, and accurately documents risk.



HOW WE DO IT

We meet each practice where they are

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Key Program Elements


Practice Engagement

We recruit providers into the program and engage practice teams for program success.

Data Analytics and Analytic Insights

We identify the most beneficial opportunities derived from aggregated data from multiple sources to analyze and identify opportunities for developing an effective target strategy to drive improvements in the practice.

Onsite Practice Assessment

We assess each practice to identify its most pressing issues and barriers, such as workload, training, use of technology, or workflow optimization, and determine the best approach for action.

Personalized Practice Action Plan

We develop a realistic plan based on analytic insights and practice assessment results that show a practice’s greatest opportunities for performance improvement.

Focused Practice Interventions


We guide practice teams through a variety of personalized interventions that drive small changes to their current operations, resulting in higher performance in their value-based contract.

Examples:

  • Outreach and scheduling training
  • Patient-centered workflow redesign
  • Patient engagement strategies
  • Gaps in care closure
  • Technology and reporting systems usage
  • HEDIS and evidence-based care education
  • HCC Coding
  • Billing and coding training
  • EHR optimization

Robust Toolkit


To start a practice moving forward from where they are today, we provide a robust toolkit equipped with industry-leading best practice templates, processes and procedures, tip sheets, and customized tools.

Features


  • Scalable and replicable program
  • Staff augmentation or full out-sourcing capability
  • In-practice coaching; hands-on instruction and assistance to modernize care delivery
  • Data-driven approach to optimize practice performance
  • Ongoing data collection and practice monitoring
  • Best practice quality improvement interventions
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Our unique data-driven approach known as Practice Catalyst drives improvements at the point-of-care.


Talk to us about
what we can do for you.