The transition to value-based care and reimbursement is underway. EHRs, alone, can’t improve key outcome measures. Enli solutions deliver ﬁnancial return and position providers for long-term success.
Healthcare providers and risk-bearing organizations require new processes and tools to better manage the health of populations and individuals. Enli PHM solutions address the most pressing challenges of:
Generates an intelligent care plan that improves clinical workﬂows and outcomes.
Delivers meaningful clinical and economic beneﬁts immediately
Quickly leverages clinical data to drive better ﬁnancial outcomes for the organization.
Enli risk stratiﬁcation solutions enable provider organizations to pursue payment incentives and value-based programs. By identifying both non-clinical and clinical determinants of risk, prioritizing risk groups, and aligning cohorts with best practice care plans, Enli drives early interventions within the patient population.
Enli value-based programs help provider organizations more effectively coordinate the care of their patients. By consistently applying care management protocols to deﬁned populations, continuously informing the care team of progress toward plan objectives, and optimizing program resources, Enli programs standardize best practices, improve administrative and clinical efﬁciency, and increase practice revenue.
Enli care delivery solutions have been intentionally developed for high-functioning primary care and clinically integrated networks. They streamline care delivery by identifying hidden risks and care opportunities, reducing unwarranted variation in care, and delivering a highly individualized patient experience.
For a Quickly Evolving Market
Value-based reimbursement (VBR) is quickly coming into focus. The Centers for Medicare and Medicaid Services continues to shift the payment model toward VBR. Commercial insurers are following their lead. At the same time, providers who are closing care gaps—a primary objective of value-based care—are generating incremental fee-for-service revenue, while positioning themselves for downstream risk.
The Centers for Medicare and Medicaid Services (CMS) reimburses providers who actively manage care delivery for Medicare patients suffering from two or more chronic conditions. The program, known as Chronic Care Management or CCM, was designed to help participants build the competencies required to succeed in value-based care and reimbursement.
PRIMARY CARE PLUS
PRIMARY CARE PLUS
CPC+ is a region-based, multi-payer program that rewards value and quality through an innovative payment structure tied to the medical home model. It represents CMS’ largest investment in primary care to date. CPC+ offers participating practices a new revenue stream, a scalable model to implement other value-based initiatives, and an exemption from the Merit-based Incentive Payment System (MIPS).
The Medicare Shared Savings Program was established by CMS to facilitate coordination and cooperation among providers to improve the quality of care for Medicare Fee-For-Service beneficiaries and reduce unnecessary costs. Eligible providers, hospitals, and suppliers may participate in the Shared Savings Program by creating or participating in an Accountable Care Organization (ACO).
PCMH defines a philosophy of care—and provides an operational model—that is centered on the needs and preferences of each patient, delivered by a coordinated, physician-led team of care providers, across a healthcare system that uses new workﬂows and technologies to make care more accessible. The focus is on quality and safety, providing the information and support that patients need to participate in their care and make more informed decisions about their health.
Volume and throughput continue to impact the patient-provider relationship, measures of patient and care team satisfaction, and the financial performance of physician practices. Technology and configurable programs systematize clinic workflow and prioritize care team tasks to improve practice efficiency, as well as satisfaction and financial performance. Enli programs, including Pre-visit Planning and Team Huddling, are accessible via forms directly integrated into your existing system of record—maximizing opportunities to plan for, and close, all prioritized gaps in care.
Tracking referrals ensures patients are properly managed through the entire episode of care—enhancing the patient experience, improving quality and outcomes, and maintaining the integrity of established delivery networks. Enli’s Referral Tracking program offers direct integration with electronic health records to accept referral orders in real-time. It provides a single-screen view of the workflow, including the steps required to complete a referral. And it populates a referral tracking dashboard to monitor performance.
TRANSITIONAL CARE MANAGEMENT
Patients eligible for Transitional Care Management (TCM) are tracked and managed in a shared workflow program powered by Enli’s team-based tasking software – CareManager Central Worklist. Critical actions supporting CMS’s TCM reimbursement program are asigned to members of the care team, and progress is tracked and recorded for easy reporting.
Enli population health management solutions bi-directionally integrate with leading electronic health record platforms to ensure data integrity, maintain workﬂow, and support clinical decision-making. Established integrations include:
Supported by Partners
Strategic partnerships and alliances extend Enli’s industry-leading population health IT capabilities and provide solutions in international markets
Continuum Population Health Management Services brings a next-generation healthcare platform and strategy to health systems, physician groups, enterprises, and strategic partners.
GE Healthcare’s IT solutions help enhance patient care and operational efficiency for healthcare providers, from independent physician practices to integrated delivery networks. GE distributes Enli population health management software to its Centricity customers, and provides ongoing service and support.
Healthjump allows organizations to aggregate and gain access to data that resides within health information systems. It provides connectivity, extracts data, and securely transmits it to Enli population health management applications.
NTT is an IT services provider recognized for its depth in vertical industries, including health IT, and for its offerings around infrastructure services, cloud services, application services, and business process outsourcing.
As a member of Oracle’s PartnerNetwork (OPN), Enli has achieved Oracle Validated integration with Oracle Enterprise Healthcare Analytics, a suite of advanced data warehousing and analytics solutions designed for healthcare organizations.