TAMPA, Fla., Oct. 15, 2019 /PRNewswire/ — MHK (formerly MedHOK), part of the Hearst Health network, announced today the launch of the next version of its CareProminence SaaS platform, introducing new features and functionality to help managed care organizations meet changing regulatory requirements, streamline operations, enhance user productivity, and improve member care.
The MHK CareProminence platform offers health plans, PBMs, and provider organizations integrated, cloud-based technology to improve compliance, efficiency, quality, and care across Medicare, Medicaid, and commercial lines of business. The next version of CareProminence offers many new capabilities and feature enhancements, including, but not limited to:
- New AI features to streamline processes and support member relations. Moving beyond traditional OCR, key case data is extracted from any form or image further automating case intake. Member relations are enhanced by AI sentiment analysis that evaluates and quantifies the severity of incoming member correspondence for case prioritization. Separately, sentiment analysis facilitates more effective outgoing member correspondence based on reading level and sentiment.
- Long Term Services & Supports (LTSS) functionality is now available for plans managing LTSS members. Users can now create and track monthly budgets and service plans, as well as capture data needed for regulatory reporting.
- Expanded clinical integrations help expedite medical prior authorizations with new real-time, direct access to MCG Cite AutoAuth with evidence-based care guidelines, and to Change Healthcare InterQual Connect™.
- Enhanced reporting capabilities through an expanded business intelligence tool include workflow improvements that now allow users to create, schedule, and share reports, as well as view reporting history, all from within the platform.
- New chat features now allow users to collaborate on cases in real time, expediting case collaboration and eliminating time-consuming follow-up tasks.
- New compliance updates keep plans compliant and improve Star ratings. Updates include, but are not limited to, functionality to help plans meet requirements resulting from the new Medicare Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance.
“These are just a few of the newest features and enhancements of the CareProminence platform. MHK is committed to continuously improving our technology and helping plans improve compliance, care, and efficiency,” commented Marc Ryan, MHK’s executive vice president and chief operating officer. “We keep a constant pulse on the needs of our customers and changes in the industry to ensure MHK and its customers are at the forefront of value-based care.”
Through structured, automated workflow and built-in compliance features, CareProminence offers solutions that bring every care moment in a member’s health journey together. The platform is pre-integrated with critical industry data sources that healthcare companies rely on to deliver quality care and offers a flexible architecture that seamlessly integrates with homegrown and third-party customer systems.
CareProminence solutions are available to support care management; medical utilization management and pharmacy prior authorizations; complaints, appeals, and grievances; medication therapy management and opioid/drug safety monitoring (MTM/OMS). With the member at the center of care, through a core 360Member™ record, users gain a comprehensive view across the member care journey. All care moments, critical member data, and interactions are captured in a single member record, equipping users with full knowledge of the member to make the most informed care and service decisions in support of optimal outcomes.
About MHK (Formerly MedHOK – Medical House of Knowledge)
MHK, part of the Hearst Health network, is a Medical House of Knowledge, where care and knowledge converge. The only service provider that combines pharmacy and medical, MHK’s mission is to drive better member care in a changing healthcare environment by bringing every care moment in a person’s health journey together through an integrated platform. MHK is committed to helping health plans, PBMs, and provider organizations improve quality of care, enhance operational efficiency, maximize revenue, and meet compliance demands. Three of the top five and six of the top ten health plans are served by MHK and forty percent of all 4-5 Star Medicare health plans utilize MHK solutions. For more information, visit mhk.com.
About Hearst Health
The mission of Hearst Health is to help guide the most important care moments by delivering vital information into the hands of everyone who touches a person’s health journey. Each year in the U.S., care guidance from Hearst Health reaches 85 percent of discharged patients, 205 million insured individuals, 90 million home health visits and 3.2 billion dispensed prescriptions. The Hearst Health network includes FDB (First Databank), Zynx Health, MCG, Homecare Homebase, MHK (formerly MedHOK—Medical House of Knowledge) and Hearst Health Ventures (www.hearsthealth.com). Hearst also holds a minority interest in the precision medicine and oncology analytics company M2Gen. Follow Hearst Health on Twitter @HearstHealth or LinkedIn @Hearst-Health.
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