SymphonyTM Drives Patient-specific, Role-based Activities to Simultaneously Comply with Clinical Protocols and Payer Contract Requirements
Optima Health, a Virginia based health plan with over 451,000 members and over 20,000 participating healthcare providers, today announced a phased rollout of the Symphony workflow management platform from Performance Clinical Systems to select primary care practices within their network. Symphony provides a tool that standardizes robust outreach protocols while allowing for detailed data capture of clinical, social and environmental factors relevant to care management success. Symphony allows for proactive management of patient outreach across various roles and clinical settings within team-based care models. Algorithms tailor “on the fly” checklists based on case-specific care needs, prior patient encounters, payer contract requirements, and the specific role of a care team member. Additionally, Symphony creates an electronic trail for care and contract compliance reporting.
“One of our key population health initiatives is improving outcomes by intensifying care management for our members with chronic conditions while simultaneously improving care delivery efficiency and standardization among the care team delivering that care,” said Tom Lundquist, Senior Vice President and Chief Medical Officer at Optima Health. “We want the care teams not only to be able to improve the clinical care and impact of the outreach, but also to work more effectively in improving care quality and cost efficiency. The Symphony platform enables a systematic approach for our provider teams to efficiently focus on delivering high-quality care without requiring them to be experts on each patient’s specific payer contract,” he added.
The cloud-based Symphony is accessible across clinical settings and locations and works in unison with traditional electronic medical records. It is highly configurable and rapidly optimized for shifting clinical, contractual, and organizational requirements.
“Optima Health is on the forefront of building infrastructure to support new chronic condition management programs and payment models that enables them to better partner with physicians in their network. We’re very excited to be part of their vision,” said Performance Clinical Systems co-founder, Jeremy Nobel, MD, MPH.
Through Symphony, Optima Health can enable their provider network to take advantage of Medicare’s new Chronic Care Management (CCM) code, which allows for billing of non-face-to-face chronic care management services as of January 1.
“The new CCM code relies heavily on electronic data capture and documentation by physicians and non-physician clinicians for things such as physical, mental, cognitive, psychosocial, functional, and environmental assessments. This is a core capability of our Symphony workflow platform,” Dr. Nobel noted. “Being able to take advantage of these new value-based payer opportunities is critical to a provider practice’s economic success and survival,” he added.
About Optima Health
Optima Health, based in Virginia Beach, Virginia, provides health insurance coverage to more than 451,000 members. With 30 years of experience in the health insurance arena, Optima Health offers a full suite of commercial products including consumer-directed, employee-owned and employer-sponsored plans, individual health plans, employee assistance programs and plans serving Medicare and Medicaid enrollees. Our provider network features 20,000 providers including specialists, primary care physicians, and hospitals. Optima Health offers programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services as well as pharmacy management – all to help our members improve their health. Our goal is to provide better health, to be easy to use and offer services that are a great value. To learn more about Optima Health, please visit www.optimahealth.com.
About Performance Clinical Systems
Performance Clinical Systems is a privately held healthcare information technology company based in San Francisco, California and Boston, Massachusetts. Founded by two physicians, its cloud-based workflow management platform, Symphony™, proactively manages patient outreach and encounters across various roles and clinical settings within team-based care models. Algorithms tailor “on the fly” checklists based on case-specific care needs, prior patient encounters, payer contract requirements, and the specific role of a care team member. This approach enables efficient and scalable patient engagement models which are highly personalized. Additionally, Symphony creates an electronic trail for care and contract compliance reporting.
The company’s solutions are attractive to performance-oriented health care providers and payers because they are quickly embraced by clinicians, deployed rapidly (within 60 days) and work alongside or as a layer on traditional enterprise HIT systems. Most importantly, Symphony contributes significantly to a provider’s ability to handle shifts in payment models, such as Accountable Care Organizations (ACO’s) and Patient-centered Medical Homes (PCMH), which reward better care at lower cost. For more information, visit www.performanceclinical.com.
