CareOptimize and Analitico Rise to the Challenges of Value-Based Care

The Centers for Medicare & Medicaid Services (CMS) recently called for a greater national commitment to value-based care, based on Medicare claims data showing the effects of COVID-19 on Medicare beneficiaries. Value-based reimbursement links payments to patients’ health outcomes and quality of care. It’s been the direction healthcare is heading, and the pandemic has only accelerated the movement and highlighted the benefits to patients and practices with a comprehensive, well-implemented value-based program.


Miami, FL -- (SBWIRE) -- 07/14/2020 -- The Medicare population as a whole is more vulnerable because of age and the propensity for chronic conditions. The CMS data revealed what has long been implicit: health outcomes worsen even more when the Medicare beneficiary comes from a lower income racial and ethnic minority group.

According to CMS, well over 100,000 Medicare beneficiaries have been treated at hospitals for COVID-19, which equates to 175 COVID-19 hospitalizations per 100,000 Medicare beneficiaries. Medicare and Medicaid (dual-eligible) beneficiaries also saw considerably high rates, with more than 450 hospitalizations per 100,000 beneficiaries. Dual-eligibles also exhibited a higher infection rate than those only enrolled in Medicare, and COVID-19 rates are higher in dual-eligible populations across all age, sex, and race/ethnicity groups.

While Value Based Medicine is a new concept for many, CareOptimize and Analitico are well poised to assist practices with the process of transition. They have been working in the value-based space for more than 15 years and have seen the opportunities it presents to practices both large and small. They work directly with full-risk centers that epitomize the most extreme use of Value Based Medicine. In addition to guaranteeing the most comprehensive care coordination that can actually bring in revenue and promote cost savings, CareOptimize ensures every healthcare dollar is wisely spent, leading to greater savings and better outcomes – the perfect value-based mix.

Value-based models rely on care coordination and require a greater amount of data capture and analytics. The right data platform produces information that can be shared across the healthcare continuum to move programs forward. Analitico is a robust, user-friendly tool that ceaselessly compiles and analyzes information from various sources of data, translating it into actionable solutions to complex regulatory ventures. The rules engine easily and efficiently exposes gaps in quality measures and coding, putting information at the point-of-care in a standardized checklist for opportunities, resulting in higher scores and revenues.

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About CareOptimize
CareOptimize provides healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.