payer-overview
payer-overview

Better Health Plan Performance

with an Entire Suite of Solutions

Innovaccer helps in driving more collaboration and connectivity among payer, provider, and member stakeholders- a truly virtuous cycle of aligned incentives and performance.

Explore how healthcare payers can contribute to high-quality, affordable care delivery

Enabling healthcare payers to go beyond traditional payer-centered levers to empower providers and members on shared challenges and improve population health outcomes.

icon

Integrate siloed data sources beyond claims

icon

Holistic provider views on a patient’s health

icon

Coordinated care activities

icon

Consumer-oriented experience

icon

Proactive approach to performance

Healthcare Interoperability To Connect The Care Teams Across The Us

Providing data transparency in healthcare a new meaning.

Read the whitepaper now.


Enhance Network Performance With Innovaccer’s Suite Of Solutions

Provider Point Of Care

Provider Point Of Care

Leverage a novel, in-workflow approach to enable cost-effective care delivery at the point of care without any EHR integration dependencies. Give providers access to care insights and enable priority actions that they cannot take with the help of the EHRs alone. Assist providers with resources that can help them improve clinical outcomes and boost the overall network performance.

  • Close coding and quality gaps to improve plan performance
  • Streamline referrals and reduce network leakage
  • Engage providers on care management priorities
  • Leverage seamless prior authorization process
  • Deliver actionable care insights
  • Offer omnichannel provider - payer - member communications
payer-overview

Payer Cost Of Care

Payer Cost Of Care

Intelligently drive care management and utilization management workflows, social determinants of health (SDoH) priorities, and improved cross-stakeholder communications. Facilitate technology-enabled improvements to assist providers in delivering better care and at the same time, boost cost of care performance of the network.

  • Close the loop with providers on identified coding gaps
  • Set up centralized referrals desk for scheduling needs
  • Drive care management outcomes with provider & member engagement
  • Streamline processing of prior authorization requests with automated workflows
  • Connect high-risk members with SDoH resources
  • Leverage holistic care insights for improved care coordination
  • Offer omnichannel payer - provider - member communications
payer-overview

Member Engagement

Member Engagement

Boost member enrolments and retain existing enrollees by transforming your member engagement strategies. Strive for a consumer-oriented experience with care navigation, care program, education & resources, and care team communications offerings for your members. Create more value for the members of your network.

  • Automate member outreach campaigns for specific priorities
  • Empower members to navigate their own care (e.g., referrals)
  • Engage members with their care programs
  • Deliver seamless access to member education & resources
  • Offer omnichannel member - provider - payer communications
payer-overview

Network Management

Network Management

Exercise complete control over your network with this solution and identify gaps that are causing obstructions in achieving efficiency. Manage your provider contracts and leverage real-time insights for interventions-driven performance improvement. Take corrective steps to ensure the optimal performance of your network.

  • Build a foundational contract & provider directory management
  • Deliver real-time performance insights
  • Drive network performance interventions
  • Facilitate design of new networks
  • Offer omnichannel provider - payer - member communications
payer-overview

Interoperability Platform

Interoperability Platform

Deliver the foundational interoperability platform needed to unlock the full potential of your health plan’s data and analytical insights. Leverage our platform to address priority quality & cost needs, and to meet payer API’s regulatory requirements. Enhance member satisfaction and provider performance to achieve excellent network performance.

  • Deliver foundational Data Activation Platform to support front-end applications
  • Access digital chart retrieval to drive coding gaps closure
  • Integrate clinical data needed for quality measures’ supplemental data submissions
  • Complete critical payer APIs as per regulatory requirements
  • * Footnote: Blue Button 2.0, CMS rule 9115 on interoperability & patient access
payer-overview

Provider Point Of Care

Leverage a novel, in-workflow approach to enable cost-effective care delivery at the point of care without any EHR integration dependencies. Give providers access to care insights and enable priority actions that they cannot take with the help of the EHRs alone. Assist providers with resources that can help them improve clinical outcomes and boost the overall network performance.

  • Close coding and quality gaps to improve plan performance
  • Streamline referrals and reduce network leakage
  • Engage providers on care management priorities
  • Leverage seamless prior authorization process
  • Deliver actionable care insights
  • Offer omnichannel provider - payer - member communications
payer-overview

Payer Cost Of Care

Intelligently drive care management and utilization management workflows, social determinants of health (SDoH) priorities, and improved cross-stakeholder communications. Facilitate technology-enabled improvements to assist providers in delivering better care and at the same time, boost cost of care performance of the network.

  • Close the loop with providers on identified coding gaps
  • Set up centralized referrals desk for scheduling needs
  • Drive care management outcomes with provider & member engagement
  • Streamline processing of prior authorization requests with automated workflows
  • Connect high-risk members with SDoH resources
  • Leverage holistic care insights for improved care coordination
  • Offer omnichannel payer - provider - member communications
payer-overview

Member Engagement

Boost member enrolments and retain existing enrollees by transforming your member engagement strategies. Strive for a consumer-oriented experience with care navigation, care program, education & resources, and care team communications offerings for your members. Create more value for the members of your network.

  • Automate member outreach campaigns for specific priorities
  • Empower members to navigate their own care (e.g., referrals)
  • Engage members with their care programs
  • Deliver seamless access to member education & resources
  • Offer omnichannel member - provider - payer communications
payer-overview

Network Management

Exercise complete control over your network with this solution and identify gaps that are causing obstructions in achieving efficiency. Manage your provider contracts and leverage real-time insights for interventions-driven performance improvement. Take corrective steps to ensure the optimal performance of your network.

  • Build a foundational contract & provider directory management
  • Deliver real-time performance insights
  • Drive network performance interventions
  • Facilitate design of new networks
  • Offer omnichannel provider - payer - member communications
payer-overview

Interoperability Platform

Deliver the foundational interoperability platform needed to unlock the full potential of your health plan’s data and analytical insights. Leverage our platform to address priority quality & cost needs, and to meet payer API’s regulatory requirements. Enhance member satisfaction and provider performance to achieve excellent network performance.

  • Deliver foundational Data Activation Platform to support front-end applications
  • Access digital chart retrieval to drive coding gaps closure
  • Integrate clinical data needed for quality measures’ supplemental data submissions
  • Complete critical payer APIs as per regulatory requirements
  • * Footnote: Blue Button 2.0, CMS rule 9115 on interoperability & patient access
payer-overview

Innovaccer’s solution suite is customized to your line of business- we focus on high-value use cases critical to the success of your line of business:

Medicare Advantage

  • Close coding gaps to improve risk adjustment revenues
  • Close quality gaps to improve Star ratings
  • Increase plan enrollment and membership retention
  • Reduce out-of-network referrals leakage
  • Improve care management outcomes for priority chronic conditions

Medicaid

  • Close quality gaps to improve performance ratings (per State Medicaid agency-defined metrics)
  • Improve health outcomes with comprehensive social determinants of health (SDoH) program
  • Drive care management outcomes for highest risk members

Commercial

  • Close quality gaps to improve plan performance
  • Reduce out-of-network referrals leakage
  • Increase member and employer satisfaction with consumer oriented-experience

Healthcare’s First Tool For Payers To Evaluate All The MA Plans Across Us

Assess the success rate of your MA Plan and get insights into devising strategies to improve your Star Ratings.

payer-overview

Suite Of Offerings To Meet Priority Payer Needs

We deliver a suite of solutions that leverage synergies across categories of offerings and are designed to work with your existing workflows and systems to meet your needs.

Please enter valid name.
Please enter a valid email address.
Please enter valid contact number.