our services

Building a Value-Based Strategy

open-close-to-view-services

CareMount Health Solutions (CMHS) help providers develop and execute on a population health strategy including development of risk-based contract optimization, population health analytics, and clinical care redesign that transform group practice reimbursement models from fee-for-service to value.

Our value offerings allow physicians to achieve economies of scale and performance:

  • increase the primary care patient base and patients assigned under risk-based contracts
  • expand the physician-led delivery system through preferred provider contracting strategy
  • coordinate transitions of care from inpatient and skilled nursing facilities to reduce post-acute care costs
  • improve quality scores
  • reduce unnecessary and expensive variation in clinical care
  • recapture service outmigration and boost in-network referrals

Our Value-Based Strategy offerings include:

  • Physician-focused Risk Contracting and Management
  • Clinical Care Coordination and Quality Improvement
  • Population Health Data Analytics and Performance Management
  • Preferred Provider Network Development

Physician-based Risk Contracting and Management:  Expert guidance on risk contract participation and compliance including payment model administration, financial analysis, preferred provider network management and contract administration, coordination of clinical, care management, billing and coding services for commercial and government value-based contracts, including Accountable Care Organizations (ACOs).

Clinical Care Coordination and Quality Improvement Services: Staffing and tools to transform clinical workflows to thrive under risk-based contracts.  Enhanced patient engagement and point of care education on value-based programs.   Coach and implement a patient centered, team-based care model.

Population Health Data Analytics and Performance Management: Integrated and proprietary analytics platform focused on operational performance and actionable insights. Easy-to-use and focused on the operational metrics that drive performance: patient risk stratification, delivery system utilization and cost analysis, transitions of care, quality and revenue programs.

Preferred Provider Network Development: Improve managed care contracts by repositioning the physician at the center of care delivery. Position the group practice for total cost of care risk and capitation, but at the right pace and timeline and with appropriate financial protections in place.

Building Better Margins

open-close-to-view-services

An intelligent finance function makes claims and payment data more timely, accessible and actionable. CareMount Health Solutions (CMHS) offers revenue cycle data-driven analytics to optimize operations and offers strategic direction for new revenue generation and revenue capture.

Our Revenue Cycle Management includes:

  • Claims Processing
  • Billing
  • Coding
  • Credentialing
  • Patient Online Payment System
  • Statement Processing

In order to enhance returns and reduce costs, CMHS also supports medical groups by preparing and delivering financial forecasts, compensation reports, balance sheets, profit and loss statements, accounting controls, audit facilitation, payroll, tax preparation, key financial performance indicators all with the goal of increasing collections, reducing the cost to collect, and achieving scale.  CMHS performs practice analysis of coding patterns, billing and documentation compliance ensuring services comply with applicable statutes, regulations and rules pertaining to Medicare, Medicaid and all of other payors.  Our clients gain efficiency, insight, and actionable intelligence through technology-enabled workflows, real-time dashboards, and practical analytics. The improved margin can be reinvested toward the medical group’s mission — be it caring for patients, providers, or the greater community.

Building a Better Administrative Strategy

open-close-to-view-services

Managing a medical practice takes valuable time away from providing patient care – that’s where CareMount Health Solutions (CMHS) works with the medical groups to develop real-world business strategies that align clinicians and administrators with the medical group’s greater goals. The administrative team offers management of capital and operating budgets, review of day-to-day operations including scheduling, billing, and collections, information technology and data security among other operational services that ensure the business objectives of the practice are met. CMHS offers physicians, providers, and healthcare leaders a new approach to “managed care,” one that understands both the challenges and the opportunities within each individual practice while avoiding disruption of current processes or relationships.

CMHS administrative services include:

  • Provider Relations and Governance
  • Patient Experience and Measurement
  • Human Resources
  • Facilities Management
  • Compensation Model
  • Information Technology

Provider Relations and Governance: CMHS utilizes a working partnership between physician leaders and administrative operations. Our strategies are aligned and culminate around a high level of performance and engagement of physicians and staff. CMHS is governed by likeminded; quality-focused professionals who help promote trust and teamwork among physicians and leadership.

Patient Experience and Measurement: CMHS assists in delivering an effective patient experience across all consumer touch points including telephone, online, and direct patient contact. Patient experience measurement and improvement is a key strategy to support ACO success—to both optimize shared savings as well as improve loyalty. CMHS delivers key patient experience insights to medical groups with standardized tools that measure patient feedback and drive patient loyalty.

Human Resources: Gaining access to top physicians and exceptional clinical and non-clinical staff is part of CMHS comprehensive and proven recruitment model. CMHS has developed a methodology that results in the hiring of quality clinicians and physicians across the full spectrum of specialties.  Our model assists medical groups with the creation and implementation of recruitment, hiring, orientation and retention processes including employee recognition programs and annual performance assessments as needed.  We provide medical groups with management training that enables the development of their employees through the coaching, counseling and performance improvement.  In addition, CMHS provides input and guidance with the development of employee handbooks and policies. We also offer our clients with assistance in developing staff compensation structures, benefits consultation, creating Total Rewards statements, and developing and implementing employee engagement surveys.

Facilities Management: CMHS provides oversight and guidance as it relates to building site maintenance, real estate negotiation, facility purchase and lease transactions, including investment analyses and will prepare and oversee physical space planning as determined by the needs of the medical group.

Compensation Model: In alignment with the strategic plans of a specific medical group, CMHS offers guidance on a wide variety of compensation structures for physicians and staff taking into account the legal and regulatory framework that govern compensation as well as market survey benchmarks.  CMHS offers analysis for both physicians and support staff in alignment with geographic regions.

Information Technology and Integration: Many medical practices are absent of the internal expertise required to evolve their applications, infrastructure or processes to meet the increasing demands of a changing health care delivery model.  The CMHS IT Team offers clients expertise in leveraging existing assets and extending their usability via a suite of integrated products that meet the demands of Physicians, Operating Staff and Patients.

Building a Better Clinical Operation

open-close-to-view-services

CareMount Health Solutions (CMHS) collaborates with each medical group’s physicians and advanced practice professionals to maintain excellent clinical care while prioritizing operational challenges in the clinical environment. CMHS ensures a culture of consistency in the organization’s clinical practice standards by establishing and reviewing systems and processes related to patient care delivery and will implement measurable performance standards.

CMHS works collaboratively with medical groups to align clinical operations with quality initiatives and standards ensuring reliable, safe operations which meet state and national clinical laws and regulations. In addition, CMHS offers physicians a variety of risk management and insurance options and aligns people, processes and technology to create a common clinical culture.