For organizations participating in Alternate Payment Mechanisms (APMs) like ACOs, Medicare Advantage, etc. the ability to enable providers to identify the best codes for optimal HCC scores, close quality gaps at the point of care, and ensure that they will be reimbursed for radiology services can make the difference between making or losing money.
CareTrak collects, integrates, and analyzes clinical (from multiple EHRS), claims, and SDOH data to identify all the appropriate HCC codes and quality gaps across all APMs as well as provides the AUC CDS mechanism to ensure that Medicare will pay for any imaging tests performed.
- Use case 1: Data integration
Collects data from all available sources (EHRs, claims, SDOH, patient-reported, devices, etc.). This data is then semantically normalized into standard terminologies, processed thru our eMPI, and combined into a single standardized longitudinal record. The provider can then view this single record at the point of care.
- Use case 2: HCC Coding
Supports the provider at the point of care by analyzing the structured and the unstructured data in the patient's consolidated medical record to ensure that each patient in a risk program (like Medicare Advantage) has the most appropriate diagnoses documented to ensure optimal HCC coding. The app tracks which patient record the provider is viewing in Cerner and displays suggestions for missing or more appropriate diagnosis codes based on that patient's longitudinal record.
- Use case 3: Quality care gaps
Supports the provider in improving quality by presenting quality-related care gaps derived from the consolidated longitudinal patient record. The quality gaps can cover any quality program the provider is involved in, including HEDIS, Commercial, ACO, MIPS, etc.
- Use case 4: AUC
From Jan 2023 onwards, CMS will require that any provider ordering any advanced diagnostic imaging services (MRI, PET, CT scans, etc.) must consult a CMS qualified Clinical Decision Support Mechanism (qCDSM) prior to placing the order. The qCDSM must generate and provide the ordering provider a unique code that can be used to trace that such a consult happened prior to the order being placed. CareTrak allows the provider to fulfill this requirement at the point of care without requiring them to leave Cerner.
Available in These Countries
- Compatible Cerner platforms (PowerChart, Patient portal, Mobile devices, etc.) Powerchart
- Latest version of app 188.8.131.52 key updates
- Persivia CareTrak integration with Cerner
- Compatible with IE 10 (minimum)
- SSO implemented via SMART FHIR
- List of modules
- Hierarchical Condition Category coding (HCC)
- Appropriate Use Criteria (AUC)
- Care View - Highlighting patient key health indicators
- Care Gaps
Persivia is now our population health operating system that works in close conjunction with our system wide Cerner and 20 ambulatory EHRs."
Gary Wenztloff, CEO of McLaren Physician Partners
CareTrak™ integrates the relevant data into the client's EHR and Synchronously delivers appropriate HCC codes, Care Gaps, Risk Scores, etc., to providers at the point of care in real-time.
Currently, CareTrak™ integrates within the PowerChart Patient's Chart (TOC- Table of Contents) using SMART App Launch and FHIR.