Hudson Health Plan, a Medicaid managed care organization based in Tarrytown, N.Y., is poised to roll out new software that will mine its voluminous stores of patient data to ensure that members who are in need of extra attention are directed to the nurses and case managers they need.
Acuity Advanced Care (ACUITY), is a comprehensive and integrated care management software system from Auburn, Calif.-based TCS Healthcare Technologies. The ACUITY system is a best-in-class IT platform that will support Hudson’s Utilization Management, Case Management, Disease Management, and Prevention/Wellness services.
"ACUITY will assume an integral role in empowering our team to serve the populations that we cover, who often are facing enormous social and economic challenges that complicate their health," said Hudson's president and CEO Georganne Chapin. Its "functionality will take Hudson’s care management programs to the next level by automating key workflows and making sure that the right information is getting to the right person."
To optimize the distribution of health information to support patients, health plans must process thousands of data files on a regular basis, ranging from provider and pharmacy claims to lab tests and hospital bills. When properly managed, this data can help identify which health plan members are most at risk for complications from diabetes or pregnancy, or one of many other complex medical issues.
"One of TCS’s emerging customer types are Medicaid or 'special need' health plans, like Hudson Health Plan," said Garry Carneal, vice president, strategic alliances at TCS. "Medicaid health plans are attracted to the ACUITY platform because of its robust ability to help manage challenging populations in an effective way."
"Most state funded health programs, like many in New York, are facing tight budgets in the coming years," Carneal added. "Therefore, it is important that health plans like Hudson bring to each program an integrated care management solution – which can optimize both the resources used and outcomes achieved for the program sponsor."
As part of the ACUITY platform, Hudson also has purchased a number of additional IT tools to support its special needs populations, including AcuStrat, a population stratification and automation tool that turns patient healthcare information into automated actionable events; AcuPort Advanced, a middleware software (Extraction, Transformation, & Loading) solution to link disparate information from multiple applications into one useful system; and AcuCare Programs for Asthma, Diabetes, Heart Failure, and High Risk Pregnancy. Hudson will go live with the ACUITY system later this year.
"Hudson needs to make sure we are utilizing the most up-to-date evidence-based UM [utilization management] criteria and case management guidelines to best serve our plan members,” said Janet Sullivan, MD, Hudson’s chief medical officer, “ACUITY also will help Hudson and its providers deliver the quality, evidence-based care that Hudson champions [and] will support Hudson’s efforts to identify, implement, standardize and document health programs with the ultimate goal of improving patient health outcomes.”
"Using an integrated and dynamic system like ACUITY is critical as Hudson continues to serve our health plan members, many of whom have special needs," added Peggy Leonard, senior vice president for clinical services at Hudson. "Its flexibility will help us build and respond to a number of state-sponsored programs that require specific activities and reporting functions."
With millions more people joining the insurance rolls in light of the recent healthcare reform, initiatives such as this take on increasing importance.
"The Patient Protection and Affordable Care Act requires the Department of Health and Human Services to develop and support new care management programs including several based upon 'case management, care coordination, chronic disease management, medication and care compliance initiatives,'" said Carneal. "With more individuals signing up for insurance coverage through the new federal law … the ability to support those individuals for all of their healthcare needs is critical."
"TCS looks forward to supporting Hudson’s mission to promote and provide excellent health care services," added TCS founder and CEO Rob Pock.
