Health Plans
Arcadia enables health plans to collaborate closely with their provider networks for mutual economic success under Medicare, Medicaid, and Commercial risk-based contracts.
- Support provider performance by making care and risk documentation gaps actionable within their existing clinical workflows
- Combine clinically integrated data with predictive analytics to help providers find the patients most likely to engage and close a care gap
- Improve your chase list for a better ROI on your risk adjustment program
Healthcare Providers
Arcadia helps healthcare providers remain financially sustainable as they take on increasing amounts of upside and downside risk in Medicare, Medicaid, and Commercial value-based contracts while also managing fee-for-service business.
Arcadia works with accountable care organizations (ACOs) that are hospital-based and ambulatory-based, clinically integrated networks (CINs), behavioral health networks, pediatric care systems, and other provider organizations to:
- Aggregate high-quality data from across the care continuum – EHRs, claims-based health plan data feeds, labs, HIEs, ADTs, social determinant insights, etc. – and make those data useful for value-based care
- Provide a comprehensive longitudinal health record for each patient and a comprehensive view of the population being managed, across multiple contracts
- Surface actionable insights about care gaps and risk documentation gaps – within existing clinical workflows
- Use predictive analytics to help clinicians match the right patient with the right intervention
- Execute workflows for patient outreach and care management
- Reconcile contract performance against plan-generated reporting
Employer Groups
Value-based care conversations often revolve around government Medicare and Medicaid programs or Commercial risk-based contracts driven by health plans. However, employer groups who fund coverage for their employees and families have long struggled with the challenges of managing the cost and quality of care – either independently or in partnership with a third party administrator (TPA). Arcadia can help employer groups and TPAs:
- Analyze provider network performance to understand care quality and cost variability
- Assess network gaps to better address the needs of employees and their families
- Manage pay-for-performance quality programs for participating providers
- Improve the performance of interventions like care management through sophisticated predictive algorithms
Life Sciences
Life sciences innovators have exciting opportunities under value-based care to demonstrate the value of treatments in improving patient outcomes. Arcadia helps life sciences companies partner with healthcare organizations to:
- Improve vaccination rates
- Improve medication adherence
- Support preventive care initiatives that drive clinical outcomes and reduce preventable utilization