Optum and HealthBI announced a partnership to help providers better manage risk-based contracts, starting with Medicare Advantage plans.

HealthBI software gives providers the ability to identify high-risk patients and document their efforts to close gaps in care, measures needed to earn incentives from risk-based contracts.

A portal, provided by the partners, is aimed at ending the chart chasing of documents by insurers at the end of each year, according to HealthBI President Scott McFarland, former president of population health for the Cleveland Clinic.

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Chart chasing means documents are faxed, he said, an expensive and time-consuming process.

Optum’s risk quality and network services group helps providers with the technology platform and provides the tools at the call center to ensure the practices are able to use the new workflow capabilities of the portal.

HealthBI software extracts electronic medical record data to document that the patient was seen, that the pharmacy prescription was refilled, and other information, to put in the reporting system. 

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“What’s happening in the space, there’s more and more risk at the provider level,” McFarland said. “Providers don’t have the tools to manage the workflow around value and quality-based metrics.”

The technology offers actionable data about patients, a real-time view of patient status, including during critical transitions, a single access point for multi-payer reporting and the ability to share data with plans and other providers.

The partnership makes sense in that HealthBI started in 2013 as a small custom software technology company staffed by former IT employees of UnitedHealth Group, Optum’s parent company.

Two of the largest health plans in the country, UnitedHealthcare and Aetna, use the HealthBI system, McFarland said.

HealthBI is in 63,000 practices and that number is expected to expand under the Optum partnership.

“It brings the day-to-day workflow to the practice level to manage these Medicare beneficiaries,” McFarland said.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com