Today’s health plans are facing enormous pressures – deciphering complex government regulations, managing increased access to care, and transitioning to value-based care and reimbursement models. As healthcare continues to evolve, it is essential for health plans to find efficient, effective, and quality solutions that will meet government requirements, while increasing the quality of care and lower costs of care.
ARDX’s deep rooted knowledge in healthcare legislation and our continued work with agencies within the Department of Health and Human Services (HHS), has provided us insight into understanding the demographics, chronic disease influx, and the economic and environmental trends of our nation’s communities. We evaluate your current state and determine new innovate programs to help you invest in what is keeping people healthy.
- MACRA – Quality Payment Program Solution: ARDX offers organizations a turnkey MIPS or APM quality performance solution that enables them to successfully select and track performance on all required components throughout the year in order to maximize bonus dollars and avoid penalties.
- Compliance/Security Audits & Work Plans: ARDX is uniquely suited to support Medicare health plans and ACA health plan issuers in ensuring highest accuracy in their program audits. The ARDX team consists of former CMS program leads who have directed full implementation of Medicare Part C risk adjustment, Part D payments, and ACA Premium Stabilization payment programs, including risk adjustment data validation audits. ARDX will also perform proactive compliance audits, and develop and monitor work plans using certified project and quality systems managers, especially in response to OIG penalties. ARDX can also deliver high-level security risk assessments and monitor ongoing cyber threats.
- Accountable Care Organizations / Clinically Integrated Networks: ARDX staff have helped set up independent physician ACOs and worked with clinically integrated networks to create data warehouses via extraction, transfer and load (ETL), monitor operational and clinical performance measures, and implement risk-adjusted, integrated care management strategies designed to improve care delivery, reduce the cost of care, and enhance the patient experience. ARDX also has physician and staff engagement strategies and training that speed transformation and adoption as well as tools to help organizations self-fund their IT infrastructure and administrative operations.
- Risk Adjustment & Predictive Analytics Solution: A new way for organizations to predict risks and financial outcomes for both individuals and systems by intelligently forecasting future medical events as well as uncovering missed patient chronic condition codes that if addressed could add significant revenue.
- Care Management & Rx Monitor Solution: A Care Management & Rx Monitoring solution (ASTRID) that helps risk taking organizations to navigate complex quality rating systems, target high-ROI measures, improve quality scores, and document care management activity.
- Behavioral Health Solution: A cloud-based, HIPAA compliant, patient engagement device that allows provider-directed behavioral health testing, screening and at-home monitoring for common medical conditions (e.g., depression, ADHD, anxiety, bipolar, distress, and substance abuse) clinicians face today. The web-enabled device helps practices meet depression screening requirements for PCMH and MSSP ACO measures; as well as generating additional revenue for the physician.
- ARDX University for Training & Workforce Development: ARDX offers a unique and secure web-conferencing platform (SimplyAttend) and virtual or onsite courses designed to deliver best-in-class training experiences. Not only does ARDX University make meeting HIPAA and other regulatory requirements easy each year, but it ensures your employees have the cultural sensitivity, project management (PMP, ISO & CMMI), certified coding / auditing and leadership skills to drive your organization’s success.
- Consulting & Project Management: ARDX’s boutique-style approach of collaboratively working one-on-one with our clients has enabled us to design customized and efficient solutions to successfully affect change that matters: better health, better access, and lower cost of care. Let ARDX scope and implement a project and/or help you select the right vendor so that you get it right the first time and at a reasonable price!