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Matrix Medical Network Study demonstrates value of year-round Prospective Assessment Programs

Source Matrix Medical Network
Published Date 11/5/2012
For Immediate Release
 
Michael John
Matrix Medical Network
480-862-1590
mjohn@matrixhealth.net
              PRESS RELEASE

Matrix Medical Network Study demonstrates value of year-round Prospective Assessment Programs

Medicare Advantage Plans Realize Return on Investment; Members Experience Positive Health Benefits 

Matrix Medical Network, a national leader in prospective medical assessment services for Medicare Advantage insurance plan members, has released the results of a study that demonstrates the positive impact of conducting year-round prospective assessment programs (versus second-half-of-year-only programs) for Medicare Advantage plans and members. A key finding was that a year-round assessment program conducted by employee clinical professionals led to stronger satisfaction ratings for the 5-Star Ratings’ CAHPS and HOS surveys.

The evaluation of data gathered over an extended period demonstrates the value of year-round prospective assessments conducted by Matrix-employed clinical professionals. The year-round prospective assessment program generated a significant Return on Investment (ROI) for Medicare Advantage plans and, using a specially trained employee clinical workforce rather than temporary, agency or otherwise non-permanent staff, had a positive impact on the health of members. This health benefit was achieved through higher quality assessments enabled by assessment repetition, assessment and coding consistency, and the ongoing training and development of clinical professionals conducting the assessments.

“Matrix clients received the highest quality risk assessments for their members which in turn drove positive financial impact and additional value for the client in the form of reduced medical expenses, greater medical management integration, improved member retention, and better audit protection,” said Brian Esterly, Matrix’s senior vice president of business operations. “Year-round assessments conducted by a highly-trained, employee clinical team have a demonstrated impact on a plan’s ability to substantiate submission of additional codes for proper reimbursement and have a very positive impact on the overall health of and care received by a plan’s members.”

Key findings include:

·       A year-round assessment program conducted by employee clinical professionals led to stronger satisfaction ratings for the 5-Star Ratings’ CAHPS and HOS surveys.

·       The Matrix assessment is a valuable tool to capture HEDIS measurements because second-half-of-year-only program measurements are not being collected during the HEDIS audit period.

·       Year-round assessments conducted by Matrix-employed clinical employees generate a significant ROI through quantifiable reductions in medical expenses and earlier recognition of revenue.  

·       Increases in member retention among those participating in the assessment program (an approximate 46 percent increase in retention).

·       Mitigation of audit exposure by ensuring that codes submitted can be substantiated.

·       There is greater access to plan members residing in medical facilities because of the familiarity and comfort created between Matrix’s clinical staff and facility administrators.

·       Second-half-of-year programs reduce the opportunity for annual assessments because these programs generate fewer member encounter opportunities. Summer schedules, winter holidays, and the impact of the cold and flu season all limit the number of available assessment days, a scheduling challenge that is reduced by implementing a year-round assessment program.


About Matrix Medical Network

Matrix Medical Network is headquartered in Scottsdale, Ariz., and provides in-person prospective medical assessment services that help healthcare plan clients manage costs and provide high-quality medical care. Matrix is dedicated to improving the health and lives of senior Americans; helping clients efficiently, accurately, and securely collect member health information; and establishing new standards in healthcare quality and effectiveness. For more information and career opportunities, visit www.MatrixForMe.com


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Matrix Medical Network
Scottsdale, AZ
 

Company Representatives Featured
Brian K. Esterly MBA
[Former Chief Business Development Officer]
Matrix Medical Network
 
Michael John
[Former VP Corporate Communications]
Matrix Medical Network
 
 
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