Key Ways to Support Membership Experience and Growth 

Key Ways to Support Membership Experience and Growth 

When a healthcare organization embraces the value-based care approach they accept the importance of supporting their patient membership experience, delivery of care and growth. What membership trends are important for a practice to track though? How do they position themselves to track ways to improve the delivery of care?

Read our newest resource below to find out these answers and more about key ways to support tracking trends that are impacting your membership experience and growth. 

1. Monitor Delivery of Care

An essential part of ensuring your patient population is continuously growing or staying consistent is tracking your membership trends. Tracking trends on a monthly, quarterly or annual basis for different trends is important. Trends Include:

  • By Payor Relationship
  • Practice Location
  • Insurance PCP 
  • Financial Class
  • County 
  • Chronic Condition
  • Age Group
  • New Enrollment
  • Churn Percentage 
  • Monthly Retention Rate 

Being able to identify trends with any of the above, allows your healthcare organization to identify room for improvement. For example, if you identify a loss in members two months ago at one of your locations, you may want to determine potential reasons this is happening. Maybe your marketing team stopped advertising for that location, maybe there’s a new competitor that recently opened up nearby or maybe the price changes you implemented recently have impacted the number of patients at that location. The only way to know this is to first identify the trend and then determine the reason why before it’s too late, too many members leave or revenue is impacted. Ensuring you have the right technology to identify these trends in real-time is something to consider as well.

2. Monitor Delivery of Care

Going hand and hand with maintaining or growing your membership panel by tracking, it is important to monitor delivery of care of your current patients. How does the delivery of care impact your patient panel? Over time if the delivery of care is not meeting or exceeding your members expectations, they will leave your practice and will also spread word of their experience.

Primavera’s technology provides you the technology and tools to monitor delivery of care through custom care gaps, patients risk stratification and alerting you of HCC code oppurtunity. As the healthcare industry shifts more and more towards value-based care, it is essential to ensure your organization is leaning into the change and being proactive with patients through not only monitoring care but intervening when necessary as well. 

3. Intervene When Necessary

Identifying trends in your memberships whether impacted by delivery of care or other factors, it is important to intervene when necessary. Having the right trends and data at your fingertips is essential to make decisions and intervene when necessary. A few examples of scenarios that you may want to intervene in include:

  • When a patient care gap has been identified, being able to create a action plan/case plan to resolve care gap
  • If you see a sudden increase or decrease in memberships for a specific group, determining what the reason may be 
  • Identifying patients that frequent the hospital and if there are ways to improve delivery of care, ultimately preventing readmission

Primavera provides you the right technology and tools to intervene on trends impacting your memberships and ultimately their delivery of care

Manage Your Patient Panel and Delivery of Care with Primavera Health

Taking action as a healthcare organization once you have measured, accessed and evaluated the risk and growth trends of your patient population is extremely important to ensure your organizations success. Primavera Health partners with you through our technology and advisors – allowing you to identify patient trends associated with risk, intervene on a patient level, and make continuous improvement of your patient experience and panel possible.

Reach out to us today to learn how we support you to continually improve your risk management and value-based care strategy today. 

(888) 667-2219

[email protected]

Adrian EsquivelKey Ways to Support Membership Experience and Growth 
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Take Full Advantage of the Industries Shift to Value-Based Care

Rapid changes in healthcare are emphasizing the need for you and your healthcare organization to lean into value-based care and we are here to help. Primavera advisors speak with organizations and providers that are either already in the value-based care setting and want to ensure they are successful or want to start value-based care but don’t know the next steps to take. Read below to learn more about the variety of ways we can help you embrace the industry’s shift to value-based care.

How Primavera Partners with You

1. Value-Based Care Starter

The shift to Value-Based Care is often viewed as a challenge for organizations to provide better quality and affordable care. Primavera’s Risk and Value-Based Care advisors work with you to face the challenge and equip you with the expertise and data insights to be successful in starting a new risk agreement. When you choose Primavera, you choose a team that holds extensive experience in helping you understand the payor options, hold the conversations with payors themselves and ensure risk agreements are mutually beneficial. 

2. Ensure You Are Taking Advantage of Current Risk Agreement(s)

Although a healthcare organization may already be involved in value-based care, oftentimes they don’t fully understand if they are taking financial advantage or the exact terms. We work with you to change that, providing you with the guidance to ensure you are taking financial advantage fully. 

3. Transitioning from Fee-For-Service to Value-Based Care 

Struggling to switch from a fee-to-service to value-based care model? You’re not alone! We empower you to diversify your revenue into capitation and create a fixed monthly income that is simply not possible with fee-for-service. Partnering with you to determine the most beneficial value-based care form to pursue with including: 

  • Shared Risk
  • Shared Savings
  • Bundled
  • Or Global Capitation

4. Develop Strategies to Hit Goals

When you choose our experts, they work with you to determine the right strategies to meet your goals for MRA, MLR, Membership, Patient Risk, Operational, Financial and Care Gap Goals. We partner together to make your organization’s goals a reality.

5. Professionalize Your Business for Selling or Retiring 

If you are considering selling your practice or retiring, determine the next steps to ensure the ultimate valuation during point of sale is very important. 

We work with you to strategize and determine:

  • Correct Practice Valuation
  • Prepping Your Practice For Sale
  • Buy-Sell Agreement
  • Practice Transfer Process

6. Improve Healthcare Results

  • Revenue
  • Cutting Cost
  • Volume/Membership
  • Revenue Cycle 

7. Data Insights to Make Decisions 

Primavera Health is proud to have the technology that allows you to run your practice proactively versus reactively. Our Advisory services and Analytics technology that empowers you to:

  • Track monthly top utilizers and readmission rate of your patient population
  • View care gaps as they occur, giving your team the tools to instantly resolve this gap
  • Custom risk stratification to identify your high risk patients instantly
  • Make proactive decisions backed by data 

Your Partner in Value-Based Care 

Transitioning to value-based care can be challenging; requiring resources, time, a priority shift, and evaluation but with a Primavera – it’s easier together. Let us map out the plan and tools you will need to be successful. 

Our solutions enable you to improve the quality of care and enhance the patient experience while helping you take control of your financial future. Reach out to us today or schedule your free consultation to learn how we directly support you in value-based care, creating a customized and sustainable strategy for your healthcare organization.

[email protected]

(888) 667-2219

Free Value-Based Care Consultation


Adrian EsquivelTake Full Advantage of the Industries Shift to Value-Based Care
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How to Set Your Healthcare Organization up for Value-Based Care Success

Transitioning to Value-Based Care can be a challenge without the proper guidance and tools at your disposal. Many organizations struggle with elevated financial risk, transition to quality versus quantity of care, lack of system and data integration and shifting policies and regulations that are related to Value-Based Care. All of these challenges have one thing in common though – with the right tools and experts working with you, they can be overcome. 

Primavera Health’s team of Risk and Value-Based Care advisors work with you to Discover, Guide and Implement strategies to ensure your Value-Based Care success from the very beginning. Our team works with you to embrace Value-Based Care and the many opportunities for improving the quality and continuity of care for healthcare organizations and their patients that come with it. Transitioning to it can be a challenging and involved process, so let’s look at how our risk and Value-Based Care advisors work with you. 


Our risk and value-based care advisors first work with you through a Free Consultation to discover where you are at your value-based care journey. From the beginning, we understand each organization is different, so strategy and approach must be customized based on the needs and goals of your organization. During your consultation, our advisors will work with you to discover:

  • What are your goals as an organization including membership, patient risk and financially
  • How engaged in value-based care you are currently
  • Determine specific metrics you may want to measure in improve, including MRA, MLR, Risk Stratification and Care Gaps
  • How you may benefit from our value-based care advisory services 

This discovery consultation with our advisors is essential in order for our team to help guide you to being successful.


After the initial consultation together, your Primavera advisor will partner with you to guide you based upon your immediate and future goals. We develop a step-by-step implementation process that is manageable, intentional, and paced to succeed. Paving your path to success includes working together to determine what value-based care form to pursue from Shared Risk, Shared Savings, Bundled or Global Capitation.

Guiding you is just the first step to implementing your Value-Based Care strategy. 


Having a risk and value-based care strategy and implementing that strategy can be seen as a challenge, and many organizations may not know where to start – our advisors work with you to change that. We enable you to improve the quality of care while helping you take control of your financial future. We work with you to:

  • Provide data-driven insights and trends on Care Gaps, MRA, MLA and Risk Stratification
  • Provide real strategies to focus on preventative care, which ultimately leads to less spending
  • Implement overall cost-effectiveness strategies 
  • Reduce the financial risk that comes with fee-for-service versus value-based care

Our goal is to make your organizational goals a reality by guiding and implementing a strategy that leads your healthcare organization to delivering higher-quality care while controlling your financial future. 

Real-Clients Real Results

Don’t just take our word for it, some of the results our Risk and Value-Based Care advisors have been able to achieve for organizations like yours are:

  • Membership increased by 190% between 2018 and 2021
  • MRA increased from 1.7 to 1.92 between 2018 and 2021
  • MLR decreased 3% between 2018 and 2021

We can work side-by-side with you to help achieve similar results, improving the quality, value and the experience of care for patients, to make health care better for everyone. At Primavera Health, we pride ourselves on being your Value-Based Care partner.

No matter where you are on the journey to value-based care, we offer an integrated approach to flourishing under the new model utilizing the Primavera advisors and tools. 

Let us map out the plan and tools you will need to be successful. Schedule your introduction call today. 

Free Value-Based Care Consultation

Adrian EsquivelHow to Set Your Healthcare Organization up for Value-Based Care Success
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4 Patient Patient Trends to Track in Value-Based Care

A successful healthcare organization tracks patient trends in care, cost and prescriptions, making it possible to deliver quality and improved patient care. Technology has been developed to streamline patient tracking in real-time and allow you to intervene immediately based on the data is critical. The question is – How do you know what patient trends to track? How do these trends impact your healthcare organization? 

Transitioning and being successful in Value-Based Care can be a challenge, so let’s look at what patient trends you should consider tracking to overcome that challenge. 


As your healthcare organization continues to grow, tracking membership trends is essential to spotting trends and planning strategic growth. To track important trends, you should ensure to track your patient memberships:

  • Monthly, allow you to compare progress
  • On different Levels. For example by Payors, Location, Primary Provider, Insurance PCP, Financial Class, County, Chronic Condition and Age Group levels
  • View average for each group across the board 
  • Down to members level, allowing you to spot trends you may not of been aware of
  • Membership by Eligibility versus Revenue files from your insurance payor.

Whether your organization is looking to expand or maintain current memberships, having the right tool in place to automate this tracking is key and something to consider.

Care Gaps

Patient care gaps can have a tremendous impact on your patients health and related costs if not intervened promptly. Care gaps may include specific health screenings, tests, unseen new patients and missed annual wellness visits. Depending on your patient population and their needs, typically depends on the care gaps you will want to be able to track. With that being said, you need to have the technology in place that allows you to customize what your care gaps are. The technology you use should also automatically identify care gaps for you, giving you the tools to immediately intervene to resolve gaps before too much cost incurs. 


An essential part of value-based care is to keep the cost of your patient population down. Tracking specific cost drivers and trends can allow your organization to intervene when necessary. Cost drivers include but are not limited to: 

  • High utilizers
  • Patients with frequent hospital/er visits 
  • Prescriptions
  • High risk patients 
  • Chronic conditions

All of these contribute to a high cost patient that should be closely monitored and have a related case plan to reduce cost. Depending on the number of patients you are serving, identifying the high cost patients and intervening can be seen as a challenge and a timely process. That is why Primavera offers the right tools through our Analytic technology to streamline and rid of the manual process for you. 

Patient Prescriptions

A continuous concern through healthcare is the rising cost of prescriptions. When an organization is in value-based care, this concern is no different. You need to have the ability to track the top prescriptions being prescribed, their associated costs and whether they are brand name or generic. Tracking these trends will allow you to identify room for improvement including the opportunity to switch current brand name prescriptions to generic. 

Technology to Streamline Your Tracking 

Our software solutions enable you to improve the quality of care and enhance the patient trend tracking while helping you take control of your financial future. Whether your healthcare organization is looking to track membership, care gaps, cost or prescription trends – Primavera’s technology has the tools to automate the process for you. 

At Primavera, our goal is to remove the challenge of transitioning to value-based care and help your continuous success in value-based care as well. 

Reach out to us today to learn how we support you to continually improve your patient tracking and value-based care strategy today. 

(888) 667-2219

[email protected]


Adrian Esquivel4 Patient Patient Trends to Track in Value-Based Care
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Importance of Risk Management and Value-Based Care

When a healthcare organization embraces a value-based care approach or a risk agreement with a health insurance payor, they are accepting the potential risk and reward associated with value-based care. While accepting the reward with a risk agreement may come easy the associated risk is typically not as easy for an organization to manage. With the shift to value-based care, comes a challenge of how to not only manage risk of your patient population but how to overcome the risk as well. 

Identifying and managing high-risk and potential high risk patients is critical to improving the care of your patient population, while identifying cost drivers and intervening timely to reduce the risk.

Managing risk can be done through technology:

  1. Measuring it within your patient population
  2. Assessing its cause
  3. Evaluating its impact 
  4. Identifying interventions to solve and avoid risk


Being able to identify and measure the risk of your patient population is critical in order to intervene. As more and more healthcare organizations embrace value-based care, they are embracing technology that allows them to streamline risk management and reduces admin burden. 

Measuring risk through technology includes: 

  1. Financial Risk including utilization cost 
  2. Clinical Risk of Patient(s)
  3. Measuring Quality Measures
  4. Monitoring Chronic Conditions
  5. Identifying patient gaps

Without having the proper tools, technology and procedures in place to measure the risk of your patient population, this task can seem almost impossible. 


Once your organization has the right tools and technology in place to measure the risk of your patient population, the next step is to assess the cause of the associated risk. An organization should be able to identify and assess the cause and attributions of a patient’s risk through:

  • Associated chronic conditions
  • Hospital visits, including ER versus Inpatient
  • Readmission Rates
  • MLR (Medical Loss Ratio)
  • MRA (Medicare Risk Adjustment)
  • Claim number and cost 

Assessing the cause of a high risk patient is essential to evaluating the direct impacts of a high risk patient. 


Now that you have Measured the risk of your patient population and Assessed the cause, it is important to Evaluate the impact of your patient population that is at high risk. How do you evaluate the direct impact of your high risk patients though? What is the importance of this? 

High risk patients are often considered high utilizers and high cost drivers within an organization. If you don’t identify and intervene with these patients, the patient is going to be impacted negatively and they will continue to cost your organization to lose money. With that being said, it is critical to have the right tools and technology to be able to drill down into the direct impact of a high risk patient and immediately identify room to intervene, improve patient care and decrease cost. 

Manage and Resolve the Risk with Primavera Health 

Taking action as a healthcare organization once you have Measured, Accessed and Evaluated the risk of your patient population is the final and most important step. Primavera Technology allows you to Identify patient trends associated with risk and intervene on a patient level. Intervening and planning a course of action can be executed within our Data Analytics App and Case Management App. 

Instantly identify high risk patients, view detailed clinical and financial information and intervene through creating a case plan. Cases are completely customizable depending on the patient and the associated risk. Options to intervene through a case include: Create tasks for case managers to complete, customizing a Plan of Care and Complete proper documentation of progress of patients health/cost. Primavera is continuously partnering with organizations to improve risk management by intervening with our technology while embracing value-based care. 

Reach out to us today to learn how we support you to continually improve your risk management and value-based care strategy today. 

(888) 667-2219

[email protected]

Adrian EsquivelImportance of Risk Management and Value-Based Care
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Guide to Stronger KPIs for your Healthcare Organization

A Key Performance Indicator (KPI) is a common term used in most industries, especially the healthcare industry. In healthcare, KPIs help us measure and track the performance and value of healthcare. Having strong KPIs is not only important for tracking the financial performance of an organization but also to track the quality of care provided to patients. With the shift to value-based care in healthcare, organizations may find themselves wondering how to adapt to the change and ensure they have strong KPIs in place. 

This guide will walk you through different steps you can take to ensure your healthcare organization has stronger KPIs to track performance. These steps include:

  1. Determine what KPIs to Measure
  2. Tracking those KPIs
  3. Measuring KPIs on different levels 
  4. Setting KPI goals for your staff, departments or overall organization 
  5. Streamlining your KPIs

Even if you already have strong KPIs in place, we hope this guide will help you better understand the importance of continuously tracking and improving your healthcare organizations KPIs.

Determine what KPIs to Measure

The first steps to ensure you have strong or adapt stronger KPIs is to determine what KPIs to track. Choosing the right KPIs is an essential part of having stronger KPIs. Things to consider when choosing the KPIs to track:

  • KPIs that impact or contribute your organization’s goals
  • KPIs that impact your organization financial performance
  • KPIs that promote better patient care
  • KPIs that track employee performance

Depending on your organization’s goals whether financially or clinically, KPI metrics will continue to evolve towards those directly related to value-based care and away from volume-based benefits. 

Tracking KPIs

Once your organization has established what KPIs to measure, tracking those KPIs overtime is essential. Tracking KPI performance allows you to measure trends, performance and plan for the future. Depending on the KPI you may want to track KPIs on a weekly, monthly, quarterly or annual basis. Tracking your KPIs can be a tedious task no matter the time period selected and often increases administrative burden for your organization. Organizations can avoid this burden by tracking KPI with the right technology tool in place that empowers the organization further. 

It is important to have a process and technology in place that allows you to automate track of your KPIs and customize tracking those KPIs for the time period your organization needs. 

Measure on Different Levels

Being able to track your organization’s KPIs not only on the organizational level but on the provider, payer, location and patient level is another essential part of having stronger KPIs. Many organizations may just track KPIs on a company level but it is important to drill down deeper into KPI data to identify where KPI trends are coming from. Utilizing technology that allows you to track your KPIs on different levels ensures your organization’s operational and financial tracking is accurate. 

Set KPI Goals 

What goals do you have for your healthcare organizations KPIs? Are the goals monthly, quarterly or annual goals? Can your organization actively update what these goals are to meet the changing demand of the healthcare industry? These are all important questions an organization must ask themselves to successfully set KPI goals. 

Setting goals for your KPIs is just as important as selecting your KPIs to begin with. Setting goals allows you to track performance overtime while indicating room for improvement. 

Streamline Your KPIs

Having the right system to allow you to Set, Track, Measure on Different Levels and Set Goals is essential. Primavera Health’s Performance Dashboard provides you that and more! With our Analytic technology we empower healthcare organizations to have stronger KPIs through: 

  • Tracking 50+ KPIs on a Monthly Basis
  • Set Goals for your organization monthly, quarterly or annually
  • View KPIs by a specific date range
  • Group KPIs by Primary Provider, Insurance PCP, Locations, Payors or Financial Class 
  • Easily export all data that contributed to your KPIs

Reach out to us today to learn how we can support your organization to have stronger KPIs! 

(888) 667-2219

[email protected]

Adrian EsquivelGuide to Stronger KPIs for your Healthcare Organization
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What is the Importance of Unified Data in Healthcare?

It is no secret that healthcare can be complicated and oftentimes overwhelming, and when it comes to healthcare data it is no exception. This leads healthcare leaders to ask the question how can a healthcare organization improve their information flow to ultimately improve patient outcomes? According to Healthcare IT Today, “A future of lower cost and higher quality healthcare – rapidly growing adoption of health information technology is a key lever in achieving that future. Achieving this goal; however, requires strategies and technologies for overcoming the problem of disparate”. In this article we will explore what unified data means within the healthcare industry and the challenges and benefits that your healthcare organization may be impacted by embracing unified data. 

What is Unified Data?

A unified data model brings together your healthcare organizations data from different sources into one centralized database, making it easier to analyze data. This concept is slowly being embraced by healthcare organizations, as the importance of data and value-based care increases. Unified data isn’t a trend that isn’t going anywhere anytime soon though. With that being said, with any change in the healthcare industry comes challenges and ultimately benefits as well.  

Challenges You May Face

Industry leaders are reluctant to embrace unified data because of the challenges that an organization may face. Some of these challenges include: 

  1. Different data formats from different systems 
  2. Changing industry standards
  3. Finding the right time and resources to have unified data

Although embracing Unified Data may cause you to face these challenges, keep in mind the benefits far outweigh the challenges for both your healthcare organization and patients.

Benefits of Unified Data 

The reality is data is the future of healthcare. Unified data allows you to make not only smarter decisions but decisions based upon data provided to you through your unified data approach. Other benefits include:

  1. Helps drive value in healthcare 
  2. Identifies opportunity to reduces Cost 
  3. Unlocks the value of complex healthcare data sets 
  4. Provides you a full picture of a patient health care and cost 

Many organizations are aware of these benefits but don’t know where to start and truly leverage their own data. 

Prepare for the future

Simply put, you can make Smarter, Data-Driven Decisions with Unified Data. Unified data allows you to position your organization for success by leveraging your organization’s data from as many resources as possible. Primavera partners with healthcare organizations and their leads to do exactly that.

We have the power to integrate and process both your front-end EHR/EMR data and back-end Payers data as well. What does this mean? Our Analytics platform is able to provide a clear picture in real-time of your patient population risk, financial status, clinical gaps and patient gaps. This level of data integrity and unified data allows you to have a more proactive approach with your data and not to wait for outcomes to improve.  HealthCare’s embrace of data and value-based care is not going away, and Primavera is on a mission to work with you no matter where you are at in this journey. 

Reach out to our team to learn how we can help retrieve and analyze your healthcare organizations data! 


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Adrian EsquivelWhat is the Importance of Unified Data in Healthcare?
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How to Successfully Maximize Healthcare Reimbursement and Improve Revenue Cycle

Revenue Cycle Management (RCM) is a top priority for all healthcare organizations. Balancing collection on difficult claims, keeping cash flowing for your organization, all while staying focused on delivering quality patient care can be difficult. Therefore, it’s important for every healthcare organization to have a process and billing team in place to continuously maximize reimbursement and improve revenue cycle management. Implementing and successfully running your RCM can be a challenging and involved process, so let’s take a look at what important factors contribute to maximizing your RCM. 

Financial Data Review 

Processes should be in place to review all facility data and verify patient information to ensure you are getting the most money for the services provided to their community. This ensures that all claims have been processed correctly and mediate for claims that process out of order from previous billings. 

Streamline Reimbursement

Delay or denial of claims can adversely affect the revenue cycle of a healthcare organization. You should have a billing process in place that ensures your claims will pass through the fiscal intermediary correctly the first time, ensuring you accurate and faster payments. It is essential to follow up on claims that may be sitting in an unpaid status to process them through the system faster. While streamlining reimbursement may be a timely process for a billing team, it is just as important to have a billing process that implements: 

  1. Providing reliable and accurate information
  2. Having knowledge of and meeting billing requirements for each individual payor
  3. Submitting claims within the prescribed time frame allowed
  4. Having a expert and experiences team at hand to reduce admin burden


RCM and medical billing includes protected health information, so understanding the importance of keeping records confidential is critical to your RCM. On top of that, a healthcare organizations process for collecting information from facilities and for submitting claims should be done with regard to following HIPAA standards, ensuring PHI and records stay confidential. 

Strong Billing and RCM Team 

At the core of maximizing your RCM is having an experienced and expert billing team manage your RCM. Your billing team should have a proactive strategy utilizing a combination of monitoring and prioritizing workload including stringent monitoring of timely filing and timely billing timelines. Just as important is keeping your billing team updated and trained on rcm rules is essential to financial success. 

Experience the Primavera Difference

Implement and successfully run your RCM to maximize reimbursement with Primavera Billing and RCM Services. The Primavera Approach leverages technology and deep experience in billing and coding to help your operation reach peak performance with your practice’s RCM. Providing revenue optimization and improved medical economics by reviewing all financial data, streamlining reimbursement, providing confidentiality and providing a strong billing team.  

Discover how Primavera’s leading billing and RCM services can transform your RCM. When you choose Primavera Health Billing and Revenue Cycle Management Services, you choose a team that holds extensive experience in medical billing and revenue cycle management services as well as:  

  • Extensive EMR and billing systems experience
  • Consultants are certified with multiple platforms
  • Deep experience with all Medicare, Medicaid, and commercial payers nationally
  • A technology approach, to simply data and an organization’s process to improve patient outcomes and overall practice performance 
  • A team that works alongside you to develop rules and assist with implementing new and improved RCM processes

Reach out to us today to learn how we support you to continually improve your RCM across your organization. Fill out the form below to schedule your Free Consultation with our team! 

(888) 667-2219

[email protected]

Adrian EsquivelHow to Successfully Maximize Healthcare Reimbursement and Improve Revenue Cycle
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Primavera NLS

Next level Security

At Primavera, we take security a step further to deter and prevent any cyber intrusion and protect data. We implement strict internal procedures for access control on client and patient data. The procedures we have in place are Primavera’s NLS, or Next Level Security. Our NLS ensures your data is encrypted, private and protected against cyber-attacks and data breaches that impact the healthcare sector. 

Primavera NLS is a combination of Security & Compliance, Established Standards & Protocols and Secure Tools & Systems. Below list the ways we continuously strive for Next Level Security for our clients, patients and their data.

Security & Compliance 

  • HIPAA Process
  • Audit and Log Activity
  • IP Masquerading Implementation
  • Vulnerability Scans
  • Automatic Device Log Off
  • Penetration Testing
  • Two Factor Authentication
  • Secure Socket Authentication
  • Encrypted Patient Data 
  • Force Strong Passwords

Established Standards & Protocols

  • Disaster Recovery Plan
  • Firewall and Router Configuration Review
  • Establishment of Permissions
  • Compliance Program Activities
  • Security Awareness Program Training
  • System Patching and Secure Development Practices

Secure Tools & Systems 

  • SFTP (Secure Data Transfer)
  • Anti-Virus Protection
  • GCP Cloud base
  • Cloudflare
  • Web Application Firewall
  • CircleCi – CICD
  • Atlassian Suite
  • Segregated Data Storage
  • Data Access Logs 
  • Strict Authorization Protocols 

Our client’s data protection is one of the primary goals at Primavera, we always ensure your data and security is top priority.

To learn more contact our team at (888) 667-2210 or [email protected].

Adrian EsquivelPrimavera NLS
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Key Considerations in Healthcare Strategy when Transitioning to Value-Based Care 

Key Considerations in Healthcare Strategy when Transitioning to Value-Based Care 

Value-based care (VBC) is a holistic care approach and payment model, versus the fee-for-service model that largely still dominates the industry. VBC models have greatly increased in use and implementation and continue to become more widely used but it’s not an easy change for all healthcare organizations to make. Which leads to the question – 

What are the best strategies when transitioning to VBC? This blog will guide organizations towards strategies to consider when adapting VBC to ensure a successful transition.

Rethink Delivery of Care 

Transitioning to value-based care requires that healthcare system participants rethink how to deliver and compensate for healthcare. Delivery of care impacts patients and all healthcare providers involved in a patient’s circle of care. In current fee-for-service  models, healthcare is delivered and paid for by an individual patient’s visit or follow-up procedure. 

In VBC all of the services and visits necessary to treat the patient’s symptoms are bundled – and this extends across specialties to include all doctors, specialists, and nurses, as well as preventive and supportive therapies such as; doulas, counselors, and nutritionists. Delivery of care significantly shifts away from quantity to quality with VBC, with care centered around patient outcomes. Shifting to delivering quality care goes hand in hand with a holistic care approach. 

Defining “Holistic” Care

There are 2 facets to holistic care with a VBC model. One is the actual care continuum itself as we mentioned, where all services are combined. The other is the financial extension of that approach with a bundling method that combines costs for these services based on treatment outcome. In VBC models the incentive is on successful treatment and continued preventive care rather than step by step actions administered throughout the diagnosis.

Educate Healthcare Providers and Teams

Paving the path to success within an organization begins with education initiatives to accelerate the transition to VBC. The adjustment from fee-to-service to VBC can be a tedious adjustment for providers that have been practicing with the focus of quantity versus quality for years. Ensure that the entire healthcare organization is equipped to participate by educating them about the core tenets of value-based care, no matter how big or small of a role they will play.

Measuring Care Impact 

A new strategy that is needed in VBC models is to implement tools like real-time risk assessment and continuous patient evaluation through software and applications and platforms for two main reasons.

  1. Hospitals and care facilities must be able to evaluate with up-to-date information from all involved care providers and practitioners within a patient’s treatment in order to coordinate care and create accurate and effective compensation practices. Patient data must be able to be updated and communicated within standard compliances, and communication channels must be maintained between both practitioners and patients. 
  2. Providers must be thoughtful and clear. This requires a rethinking of how healthcare is delivered by providers but also all specialists the patient is going to see. It also requires that the communication between any provider and the patient is as seamless and accessible as possible. This means having a centralized method or platform that encompasses outreach, communication, provider connections, transportation logistics, and transactions across the full continuum of care.

There is no shortage of valuable data available to healthcare organizations and they must commit to quality improvements through reliable data. 

Why make the change

VBC causes healthcare leaders to rethink the processes and elements that have the greatest impact on a patient’s outcome. It also provides a clear format as to what is or is not a covered benefit for the patient. This approach leads to lower costs overall for facilities and providers through a few key shifts:

Risk analysis and shared responsibility

All providers and practitioners/departments work together to reduce collective spending. Risk is assessed and prioritization makes it easier to provide pertinent care.

Shared Savings

Financial load is shared among practitioners/providers so that saved funds in one department can be redirected to another to keep the collective on budget.

Bundling Cost

Bundling allows patients to have input on their care and opt out of services they don’t need. Patients don’t overpay, and providers can accrue savings from unused services.

Understanding the shared health needs of patients will make it easier to see how a VBC model can help you save on cost through bundling and shared savings across departments. With this information you can design your own unique solution to improving the quality of care for your patients. The analytics and data collected from Primavera’s Data Analytic platform to facilitate VBC success will make tracking health outcomes and patient data easy so you can justify and analyze cost and outcomes.

VBC creates great experiences and outcomes for patients, and generates higher bottom lines for providers. Though it is increasing in popularity, VBC is not dominating the entire market – but due to its flexibility and adaptive/integrative nature it is ideal for mitigating gaps in care that can be created by pay-per-service models. 

Patient-first care does not have to negatively impact revenue generation. At Primavera, we help you create the best strategies to implement VBC solutions into your practice. The goal is to close gaps in patient care and improve outcomes without incurring additional costs – and in fact, reducing them.

Through revenue optimization (driving down costs by improving efficiencies in coding and determining cost drivers), and identifying growth trends, we are able to help identify your specific benefits from switching to VBC. 

Reach out to us today to continue the conversation on how to position your healthcare organization to benefit from value-based care. 

Adrian EsquivelKey Considerations in Healthcare Strategy when Transitioning to Value-Based Care 
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