Enhancing care quality for ACOs using AI-powered prospective risk
When manual coding can’t keep up with ACO growth
An accountable care organization (ACO) planned to grow aggressively but needed to better understand the health status of patient populations acquired into its network to improve care.
Unfortunately, legacy processes relied too heavily on professional coders to manually review clinical documentation and struggled to scale.
AI-driven patient insights drive earlier diagnosis detection for ACOs
The ACO explored solutions and partnered with Reveleer in order to leverage our AI-powered healthcare platform to improve the speed and accuracy of data acquisition and clinical review for over 70,000 patients.
Reveleer’s proprietary AI technology, EVE™, synthesized and analyzed a nationwide network of clinical data from over 75 health information exchanges to create patient summaries with undiagnosed HCCs and supporting clinical documentation.
Reveleer then pushed these insights directly into the ACO’s provider workflows at the point of care for more precise clinical decision-making, such as earlier diagnosis detection.
Clinical insights to improved patient outcomes
Using Reveleer's Clinical Intelligence suite and EVE™ helped supplement the ACO’s in-house data with Reveleer's data interoperability and AI-powered clinical insights. From the provider's perspective, the solution delivered timely, evidence-based clinical insights with a direct impact on patient outcomes while streamlining pre- and post-encounter workflows. By introducing Reveleer into their data and quality workflows, the ACO was able to both increase the speed of clinical review as well as uncover new clinical insights for 89% of patients, resulting in a 0.13 RAF uplift opportunity.
Next steps: Drive ACO success in delivering high-quality, value-based care
Working with Reveleer has increased the efficiency of retrieval and clinical review as well as delivered insights critical to improving patient care. The ACO continues to work with Reveleer to on-board new provider groups, arming them with clinical insights that create opportunities for early detection and better care. Providers can easily access insights to support their clinical decision-making, and the ACO can reach their value-based care goals by delivering highly effective care.
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