Premier Florida-Based Health Plan Selects Health Fidelity's Risk Adjustment Solution to Optimize Risk Adjustment Accuracy, Operational Efficiency and Compliance
March 8, 2018
Florida-based AvMed has selected Health Fidelity as its technology partner for risk adjustment transformation. Health Fidelity develops innovative technologies for the value-based care era. AvMed will utilize Health Fidelity’s NLP-powered risk adjustment solution to optimize operations for its Medicare Advantage and Affordable Care Act (ACA) Individual and Small Group plan offerings.
AvMed’s Risk Adjustment Team searched the industry for a solution to augment its existing risk adjustment processes to improve the accuracy and completeness of risk adjustment results, while increasing productivity and efficiency.
“With our continuously growing membership, we were looking for a scalable solution to help improve risk adjustment, review accuracy and team productivity,” said Winston Lonsdale, AvMed Vice President of Revenue Management. “Health Fidelity provided an intuitive workflow that allowed the team to focus on value-generating activities and reduce the waste that can be inherent in a manual chart review process.”
With the deployment of Health Fidelity’s solution, AvMed’s team will identify all member risks and compliance issues and scale operations rapidly to keep pace with the growth of their membership.
“With the help of Health Fidelity’s improvements in risk adjustment review productivity, we hope to manage the growth in our membership without having to proportionately grow the size of our team to meet the growing risk adjustment burden,” added Lonsdale. “We were glad to find that their technology was well-aligned with AvMed’s focus on operational improvement, risk accuracy and compliance.”
“AvMed is a well-established organization with a history of success in Florida, which is a very competitive payer market especially for Medicare Advantage plans,” said Steve Whitehurst, Chief Executive Officer of Health Fidelity. “We are thrilled to work with such a forward-thinking organization in helping to continue their success and growth across multiple lines of business.”
Learn more about HF360 Risk Adjustment for health plans.
With headquarters in Miami and offices in most major metropolitan areas of the state, AvMed transforms lives to create a WELLfluent world. By uniting around this sole purpose over our near-50-year history, we’ve aimed to inspire our Floridian health plan Members to focus on celebrating the riches that matter most— health and happiness of the mind, body, and soul. Learn more at AvMed.org.
About Health Fidelity
Health Fidelity delivers comprehensive, scalable risk adjustment solutions for risk-bearing entities that participate in Medicare Advantage, ACA, Medicaid and Medicare ACO programs. With a combination of big data analytics and natural language processing (NLP) technology, Health Fidelity’s modern prospective and retrospective risk adjustment approaches extract valuable insights from medical charts, changing the way risk is identified, quantified and managed for enhanced operational, clinical and financial outcomes.
Health Fidelity is a registered trademark of Health Fidelity, Inc.