Children’s Community Health Plan (CCHP) has renewed its relationship with Cotiviti, a leader in data-driven healthcare solutions, to use Cotiviti’s top-performing Medical Intelligence solution. A critical part of the company’s Quality and Performance solution suite, Medical Intelligence supports population health management, clinical program design and evaluation, network management, and medical cost management. CCHP uses the solution to enable care managers to proactively manage member health as well as more effectively address gaps in care.
“To continually improve their members’ care, payer organizations such as CCHP need rapid answers to highly complex questions about healthcare costs, quality, utilization, and value, which Medical Intelligence delivers to our clients,” said Joe Morrissey, Cotiviti executive vice president of client engagement. “While Cotiviti’s expertise is in aggregating and analyzing billions of clinical and financial data points to improve payer performance, our most important work can be seen when health plans use our results to improve their members’ care. We are proud to be CCHP’s analytic partner in its ongoing efforts to holistically improve member health.”
Medical Intelligence combines Cotiviti’s industry-leading DxCG science, evidence-based clinical quality rules, healthcare utilization metrics, and claims-based HEDIS measures to enable payers to manage risk and target opportunities for improving healthcare results. Users can easily stratify and segment populations, access member-level detail, and evaluate efficiency and performance by program, provider, and more.
A Cotiviti customer since 2010, CCHP also leverages Quality Intelligence, Cotiviti’s measurement and reporting software with fully NCQA-certified quality measure logic, to inform targeted interventions. For example, with a better view of noncompliant patients across a segment of asthmatic members, CCHP was able to proactively manage this population and increase the rate of controller fills by 16 percent.
“With a frequently expanding and shifting member population, having robust tools to provide care managers with rapid access to member data is crucial,” said Lynn Kryfke, R.N., M.S.N., CCHP executive director of health plan clinical services. “Using Cotiviti’s solutions enhances our organization’s ability to fulfill our core mission to improve the medical and social well-being of our members and the community.”
Cotiviti is a leading solutions and analytics company that is reshaping the economics of healthcare, helping its clients uncover new opportunities to unlock value. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and network performance management programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit www.cotiviti.com.
Children’s Community Health Plan (CCHP), an affiliate of Children’s Hospital of Wisconsin, is an HMO dedicated to providing access to the highest quality healthcare and services to its members living in Wisconsin. CCHP is proud to serve over 140,000 members between its two products, BadgerCare Plus and Together with CCHP. CCHP is a member of the Association for Community Affiliated Plans (ACAP), which is a national trade association representing more than 70 nonprofit safety net health plans in 28 states. For more information, visit www.childrenscommunityhealthplan.org.