Health Plans

Driving Health Plan Success in Value-Based Care Models

In today’s value-based care market, health plans have more data to manage than ever. Medical Advantage’s robust portfolio of analytics, IT, and risk adjustment services – along with our team of experts ready to engage with your network and implement clinical and financial best practices – drives improvements from the practice-level up, benefiting the entire health plan.

Physicians discussing health plans at a hospital

Solutions Benefiting Health Plans and Their Care Providers

Success that Starts at the Point-of-Care

A health plan is only as successful as its member physicians – that’s why our consultants introduce best practices to boost practice – and health plan – performance in clinical, financial, and technological areas.

Risk Adjustment Assistance

When it comes to risk adjustment, increased physician engagement and buy-in can go a long way toward maximizing payer reimbursement. Our consultants use best practices and training to increase the accuracy of your population’s risk score and optimize reimbursement.

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IT, Data, and Analytics Services for Health Plans

Managing multiple locations, practices and organizations can create headaches for even the most savvy health plans. In addition to implementing optimized workflows and reporting best practices, Medical Advantage’s suite of RCM, data reporting, and analytics dashboard technologies empower health plans with the oversight necessary to get the most out of their member practices.

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A Data-Driven, Experience-Backed Track Record of Success

Medical Advantage is uniquely positioned as a bridge at the intersection of these groups, bringing to bear technological and consulting solutions to optimize practice operations – while allowing providers to continue focusing on care delivery. This ensures both providers and plans have the data and oversight necessary to boost performance on quality metrics, risk adjustment programs, and medical loss ratios – resulting in enhanced patient outcomes and profitability for all parties involved.

Services for Health Plans

Physician Group Advisory Services

Optimizing Experiences at the Point of Care

Everything flows upwards from patient experiences at the point of care. Drive health plan success with consulting designed to improve all aspects of care delivery.

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Billing and Rev Cycle Management

Billing and Coding Advising

Make the most out of what your member practices are already doing. Our billing consultants bring the latest knowledge on industry codes.

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Accountable Care Organization

RCM Advising

Our team can optimize and assist with claims and reimbursement workflows, one of the biggest areas to improve RCM.

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Healthcare Analytics Solutions

Healthcare IT Support for Analytics and KPIs

Health plans have a large amount of data from member practices to manage – let our IT consultants help you put a framework in place to do so effectively.

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Flexible Timing

Whether you’re carefully planning for the future or need our team to start right away – we can meet your timelines.

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Flexible Engagements

The flexibility you need. We can help across multiple locations in large practice groups, or keep the scope small to fit within your budget.

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