2016 HIMSS Annual Conference & Exhibition – March 1, 2016 – Talix, Inc., a premier provider of healthcare risk management solutions, today announced that Crystal Run Healthcare, a New York-based multi-specialty group practice and accountable care organization (ACO), has implemented Coding InSight by Talix to help automate risk adjustment processes, improve patient risk scoring and meet quality performance benchmarks.
“As an ACO, delivering better outcomes while meeting performance benchmarks is a top priority for us,” said Gregory Spencer, MD, FACP, chief medical officer and chief medical information officer of Crystal Run Healthcare. “We needed a better way to identify coding and documentation gaps so that our clinicians could get a more complete view of their patient populations and effectively assess and manage high-risk patients. Previously, this had been a very manual process. Coding InSight has helped us automate and streamline the entire coding process for risk adjustment.”
Integrated into Crystal Run Healthcare’s NextGen EMR system at the point of care and Mirth HIE solution at the data aggregation layer, Coding InSight leverages advanced natural language processing (NLP) technology, sophisticated clinical rules and a proprietary medical taxonomy to analyze structured and unstructured patient data from disparate sources – including free-text care plans, historical chart notes, and specialist reports – to accurately identify missed codes in patient charts. As a result, Crystal Run Healthcare clinicians can quickly identify and close missed coding opportunities at the point of care, both prospectively and in real time. Its professional coding staff is also able to more efficiently perform chart reviews and audits retrospectively.
“In 2014, only 26 percent of the MSSP ACOs actually met performance benchmarks and received shared savings payments from the Centers for Medicare and Medicaid Services (CMS),” said Dean Stephens, CEO of Talix. “Coding InSight helps ACOs take control of risk-adjusted coding for improved care management and more accurate Risk Adjustment Factor (RAF) scores. This will be even more important as ACOs move into CMS’ new Next Generation ACO Model.”
About Crystal Run Healthcare
Crystal Run Healthcare is a premier multispecialty group practice with over 350 providers in over 40 medical specialties and more than 30 practice locations in the Hudson Valley and lower Catskill region. Crystal Run has a strong commitment to primary care, employing an outstanding group of physicians in the specialties of Internal Medicine, Obstetrics/Gynecology, Family Practice, Geriatrics and Pediatrics. The practice also includes unsurpassed sub-specialists in a wide variety of medical and surgical specialties and sub-specialties. In addition to accreditation by The Joint Commission, Crystal Run is designated by the National Committee for Quality Assurance (NCQA) as a Level 3 Patient Centered-Medical Home. The practice is among the first 27 health care organizations in the nation to participate as an Accountable Care Organization (ACO) in the Medicare Shared Savings Program (MSSP). Crystal Run Healthcare achieved NCQA Level 2 ACO Accreditation in 2012, becoming the first health care organization to be so designated in New York State and among the first six in the United States. Leveraging its ACO experience, Crystal Run has entered into value-based care/shared savings arrangements with numerous commercial payers and a Medicaid Managed Care organization. As a result, contracts which reward Crystal Run for health outcomes now cover approximately 50 percent of the group’s attributed primary care patients. Crystal Run has demonstrated its ability to manage population health, improving quality while simultaneously lowering per capita cost for the patients it serves. Crystal Run Healthcare and Mount Sinai Health System have recently announced the established the Mount Sinai-Crystal Run Alliance for Healthcare Transformation, a groundbreaking partnership in which the participants will share and implement best practices, invest and share financial and intellectual resources, strengthen provider networks, and employ innovative approaches to the creation of health care value—all in furtherance of the “Triple Aim” of Better Care, Better Health, and Lower Cost. For more information about Crystal Run Healthcare visit www.crystalrunhealthcare.com, and follow us on Twitter, LinkedIn and Facebook.
Talix provides healthcare risk management solutions to help providers, payers and accountable care organizations address the challenges of value-based healthcare and risk-based contracts. Its SaaS applications leverage patient data analytics to turn structured and unstructured health data into actionable insights that drive improved risk adjustment, better patient outcomes and reduced costs. For more information, please visit www.talix.com or follow @TalixHealth on Twitter.