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Case Study

Transforming an ACO’s Healthcare Management With Hexplora’s Agile, Cost-effective Population Health Platform

By May 16, 2024October 1st, 2024No Comments

Background
Hexplora, a prominent player in healthcare technology, embarked on a mission to address the operational challenges faced by an Accountable Care Organization (ACO). The ACO struggled with an outdated platform, leading to inefficiencies, manual processes, and reliance on Excel spreadsheets to compensate for system limitations.

Challenge
The ACO’s existing platform was costly, sluggish, and failed to meet evolving needs. Users grappled with inefficient workflows, hindering their ability to deliver quality care while managing costs effectively. Real-time insights were lacking, leading to suboptimal resource allocation and compromised patient outcomes.

Solution
Hexplora deployed its population health platform, integrating claims data, real-time ADT messages, quality measures, risk-based Provider level PMPMs, MIPS data submission, and more. This unified platform streamlined operations, enhanced data insights, and empowered users with actionable analytics.

Implementation
The implementation process was meticulously executed, with Hexplora providing comprehensive training and support. Through a phased approach, the solution was seamlessly integrated into existing workflows, ensuring minimal disruption to daily operations.

Results:

1

Enhanced Efficiency

Automation and streamlined workflows led to significant time savings, with tasks completed in minutes rather than hours.
2

Improved Data Insights

Comprehensive analytics enabled better decision-making, identifying areas for improvement and targeted interventions.
3

Cost Savings

Moving away from the expensive legacy platform resulted in substantial cost reductions.
4

Real-time ADT Management

Instant visibility into patient admissions, discharges, and transfers optimized bed utilization and reduced resource wastage.
5

Quality Metrics

Continuous measurement of quality metrics facilitated real-time performance monitoring and gap identification.
6

MIPS Data Submission

A seamless data submission experience that contributed to timely data submission to MIPS and improved quality score.
7

ACO Achieved Shared Savings

Right after the Hexplora platform was introduced the ACO achieved shared savings.

Current Enhancements to Prepare for the Future

Hexplora continues to innovate, enhancing its population health solution to meet future challenges.
A few notable enhancements include:

  • Generative AI Solutions With Clinical Notes Mining
    Hexplora integrates generative AI solutions that mine clinical notes to support care management teams and quality teams. By analyzing unstructured clinical data, the solution provides valuable insights into patient conditions, treatment plans, and outcomes, empowering care teams to deliver personalized, effective care.
  • Readmission Predictor Integrated With ADT Messages
    Hexplora develops its own Readmission Predictor, seamlessly integrated with ADT messages. This predictive analytics tool identifies patients at high risk of readmission, enabling proactive interventions to prevent adverse outcomes and reduce healthcare costs.
  • eCQMs Data submission
    As CMS is changing the regulation around quality measures submission, Hexplora has now become a CMS Qualified Registry and has already supported the data submission through the new process. Hexplora is prepared to support all its customers through regulatory changes, especially in the context of eCQMs data submission.

Conclusion:

Hexplora’s population health solution has transformed healthcare management for the ACO, driving efficiency, cost savings, and improved patient outcomes. With ongoing enhancements, including generative AI solutions and predictive analytics tools, Hexplora remains at the forefront of innovation, poised to meet the evolving needs of the healthcare industry.