Solutions

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.

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Delivering Value

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:

 

Clinicians

Generates an intelligent care plan that improves clinical workflows and outcomes.

 

Administrators

Delivers meaningful clinical and economic benefits immediately

 

Information Technology

Quickly leverages clinical data to drive better financial outcomes for the organization.

Risk Stratification

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.

Care Coordination

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.

Care Delivery

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.

Chronic Care
Management (CCM)

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Chronic Care
Management (CCM)

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.

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COMPREHENSIVE
PRIMARY CARE PLUS
(CPC+)

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COMPREHENSIVE
PRIMARY CARE PLUS
(CPC+)

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).

MEDICARE SHARED
SAVINGS PROGRAM
(MSSP)

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MEDICARE SHARED
SAVINGS PROGRAM
(MSSP)

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).

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PATIENT-CENTERED
MEDICAL HOME
(PCMH)

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PATIENT-CENTERED
MEDICAL HOME
(PCMH)

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.

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PRACTICE EFFICIENCY

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PRACTICE EFFICIENCY

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.

REFERRAL
MANAGEMENT

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REFERRAL
MANAGEMENT

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 Management 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.

Seamlessly Integrated

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