Passport Health Plan Enhances Pay-for-Performance Program with ikaProHEDIS+ and ikaP4P
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SOUTHBOROUGH, Mass.–(BUSINESS WIRE)–Passport Health Plan, recently recognized by U.S. News & World Report and NCQA as one of the top Medicaid health plans in the country, has extended its relationship with ikaSystems, a premier provider of enterprise-level Web-based technologies for the payer market, to further enhance its well-established primary care provider quality recognition program. Using ikaProHEDIS+ and ikaP4P, comprehensive quality analysis and reporting systems, Passport can give its provider community more current quality information faster than ever before, helping physicians earn performance bonuses while decreasing the administrative burden of the program.
“Passport has developed a comprehensive program to reward those providers who consistently demonstrate excellence as well as to motivate all providers to improve their performance in the categories of health outcomes, member satisfaction, access to care, and cost containment,� said DeDe Davis, vice president of operations at Passport Health Plan. “Our providers are eager for current information that allows them to proactively monitor their progress toward quality goals, and ikaProHEDIS+ and ikaP4P will allow us to keep them fully informed while reducing the reporting burden on their staff as well as our staff.�
Passport began partnering with ikaSystems in 2000, using the company’s ikaProfyle, ikaUA and ikaHEDIS products to compare and communicate provider quality metrics and support the NCQA accreditation process. As a result, Passport’s Early and Periodic Screening, Diagnosis and Treatment (EPSDT) compliance rate moved from 88 to 93 percent in a year’s time. In addition, Passport was able to increase its membership while maintaining per-member per-month medical expense increases to less than 5 percent annually, significantly lower than the national average. Today, the organization serves over 145,000 members across 16 counties in Kentucky.
With the addition of ikaProHEDIS+ and ikaP4P modules, Passport gains the ability to support a sophisticated pay-for-performance program developed in close collaboration with its provider community, using a broad range of quality metrics and allowing physicians to have earlier access to the type of information that will help them maintain or improve their quality scores. All quality programs can be monitored and managed with one system, which draws upon a single data warehouse that can contain claims, laboratory, pharmacy, encounter data, practice management and electronic medical record information. In addition, physicians can clearly see the impact of incremental quality improvement on their payment.
“Passport Health Plan has a clear mission: to improve the health and quality of life of its members, which are often the most underserved population,� said Robert S. London, M.D., ikaSystems’ general manager and a nationally recognized expert in healthcare management, benefits design and medical informatics. “Physicians are the organization’s essential partners in driving quality, and ikaProHEDIS+ and ikaP4P have given Passport the functionality it needs to efficiently and proactively share information for optimal impact.�
According to Ravi Ika, president of ikaSystems, “Although for years the market has talked about integrated medical management, in health plans across the country fragmentation remains the norm. Disparate departments — disease management, case management, utilization management, medical informatics, provider contracting, provider recognition — are working separately to influence quality and costs, with little ability to share information with patients, providers or departments within the health plan. Innovators such as Passport Health recognize the need for a different, more transparent approach. ikaMM, our next-generation integrated medical management platform, has finally enabled all parties in the healthcare continuum, both externally and internally, to collaborate fully to proactively improve the quality of care and contain costs.�
About Passport Health Plan
University Health Care, Inc., dba Passport Health Plan, provides Medicaid managed care services for over 140,000 members in Jefferson and the 15 surrounding counties. The counties of service include Breckinridge, Bullitt, Carroll, Grayson, Hardin, Henry, Jefferson, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, Trimble, and Washington. Passport Health Plan is sponsored by the University of Louisville Medical School Practice Association, University of Louisville Hospital, Jewish and St. Mary’s Healthcare, Norton Healthcare, and the Louisville/Jefferson County Primary Care Association, which includes the Jefferson County Health Department and Louisville’s two federally qualified health centers, Family Health Centers and Park DuValle. University Health Care, Inc., contracts with AmeriHealth Mercy Health Plan for administrative services. AmeriHealth Mercy and its affiliates comprise the largest family of Medicaid managed care plans in the United States, touching the lives of over two million members nationwide. AmeriHealth Mercy specializes in providing management care services and management for publicly funded programs, with special expertise in Medicaid, Medicare and State Children’s Health Insurance Programs (SCHIP). For more information, please visit www.AmeriHealthMercy.com.
About ikaSystems Corp.
ikaSystems is healthcare payers’ premier provider of Web-based ERP technology for process automation and intelligence management. ikaEnterprise, the company’s flagship product, automates all key processes in the payer business cycle, supporting commercial, Medicare and Medicaid lines of business. The system consists of five stand-alone, self-service Web portals for sales/broker, administrative, employer, member and provider use, each of which are tightly integrated with business intelligence and transactional systems for core claims adjudication, care management and proactive quality measurement and reporting. Using our agile, modular technology, organizations can move quickly to lower administrative and medical care expenses through greater automation and highly intelligent decision-making. To learn more, please visit www.ikasystems.com.
