HealthMine and Pulse8 Form Strategic Partnership to Improve Health Plan Performance and Member Experience

Collaboration enables an integrated, end-to-end quality and risk adjustment solution to close critical care gaps

HealthMine, a leader in technology-enabled member engagement and rewards solutions, and Veradigm/Pulse8, a cutting-edge healthcare analytics and technology company, announced a strategic partnership to assist health plans and providers in Medicare, Medicaid, Marketplace, and Commercial health insurance programs. The strategic partnership will focus on improving risk adjustment and quality performance and aligns HealthMine’s scalable, member-centric Star Ratings and quality improvement solutions with Pulse8’s best-in-class risk adjustment data platform.

By empowering member data coordination and needs across disparate systems and departments, plan operations leaders in both Quality and Risk Adjustment can work from one playbook when engaging members to close care gaps. Never before have these two revenue-centric silos come together in a manner that dramatically improves member experience and plan success simultaneously.

Recommended AI News: HCL Technologies launches Digital Acceleration Center in Canada

“HealthMine is excited to integrate our next-gen member engagement solutions with Veradigm/Pulse8’s best-in-class analytics and provider engagement technology to offer the industry a full spectrum of real-time gap closure initiatives,” said Bryce Williams, President & CEO of HealthMine. “We are excited to help plans drive optimal interventions, and ultimately, to help members and health plans achieve the Triple Aim goal of improved health outcomes, positive experiences, and well-managed medical spend.”

“This partnership helps plans achieve high-quality, whole-person care by using real-time data to drive the next best action across the full spectrum of Stars, quality, coding, and documentation needs,” said Melissa Smith, EVP of Consulting & Professional Services at HealthMine. “We’ve been helping plans embrace this strategic approach to ‘silo-bust’ Stars, quality, and risk adjustment efforts for years, and this new technology-enabled partnership will seamlessly and efficiently provide the tactical mechanism to operationalize this vision.”

Recommended AI News: Basware Launches E-Invoice Receiving Solution Compliant with China Fapiao Regulations

Installed now across leading Medicare Advantage, Medicaid, Commercial, and ACA plans, HealthMine’s sophisticated platform enables clients to aggregate clinical and non-clinical data, segment populations based on conditions or measures, personalize member engagement efforts to simultaneously fit the population’s demographic and the plan’s needs, engage members digitally to encourage members to take needed action, and measure the effectiveness of each intervention.

Veradigm/Pulse8 enables both health plans and at-risk providers to achieve precise risk and quality scores in the Medicare Advantage, Managed Medicaid, and ACA Commercial markets as well as with Value-Based Payment models for Medicare.

“Veradigm and Pulse8 are thrilled to be partnering with HealthMine to offer this next level member engagement solution to our customers,” said Scott Filiault, Co-President & Chief Revenue Officer at Pulse8. “Pulse8’s goal is to reduce waste and eliminate unnecessary costs for health plans, and this new cross-platform communication is a perfect pairing to help close critical gaps in care with the right intervention at the right time, and only if needed.”

Health plans with significant growth, retention, and profitability targets can now leverage a connected and integrated quality and risk adjustment improvement platform to deliver vastly more coordinated programs. HealthMine and Veradigm/Pulse8 expect this collaboration to drive 5-Star member experiences by directing members to the most valuable and critical interventions in a coordinated fashion.

Recommended AI News: Cognex Presents the Edge Intelligence Platform