Population Health Management Technology

Take Your Population Health Management to the Next Level

Effective population health management requires partnership between providers and payers, integrated data, connectivity powered by an agile IT system. Further, new or enhanced care management models and a shift from fee-for-service delivery to bearing financial risk for the populations served is a part of the equation. In fact, the majority of population healthcare costs come from a small portion of the member population, but the ability to determine that subset population and influence their future utilization is critical to effective population health management (PHM) that increases quality, improves health and reduces costs.

eQSuite® Population Health Management Technology uses sophisticated software to identify high-risk, high-cost members, categorizing and prioritizing them by illness, severity of illness and identifying any gaps in care. Through predictive modeling, we are able to take your claims and other data to identify members whose health, functional ability and use of health services suggest they are good candidates for care coordination and provide the platform to guide your care for those members.

• Processes and stores medical records, claims, pharmacy, laboratory and other data feeds.
• Wholistic, evidence-based assessment tools and resources (Modified Morisky Scale to determine medication adherence, depression screening, motivation and activation assessment, literacy, psycho-social barriers and quality of life measurements).
• Predictive modeling that identifies current and future high-risk population members.
• Identifies gaps in care for both medical care and pharmacy compliance.
• Evidence-based, individualized plan of care documentation.
• Comprehensive care coordination software (patient, care coordinator, provider, client administrator portals).
• Prior authorization/retrospective utilization review and management.
• Provider channeling.

eQHealth Solutions Can Help You Answer the Most Pressing Questions About Population Health Management:

• Who are my high-risk population members?
• How much will the care for the high-risk members and the population in total cost?
• What are the gaps in care for my member population?
• How can I engage my population with educational resources, prompts / alerts for preventive medicine or chronic care?
• How can I automate healthcare management so that it is clinically effective but also cost efficient?