February 03, 2009 ikaProHEDIS+ Goes Live at Parkview Health and Passport Health Plan

Two Leading Health Plans Quickly and Successfully Add Collaborative Quality Monitoring and Communication to Their Existing Roster of ikaSystems’ Solutions

Two health plan innovators — Parkview Health Plan Services, a preferred provider organization serving northeast Indiana and western Ohio, and Passport Health Plan, which serves over 150,000 members across 16 counties in Kentucky — have gone live with ikaProHEDIS+ in record time. The comprehensive quality improvement and cost containment solution from ikaSystems, a premier provider of enterprise-level Web-based technologies for the payer market, will help both organizations enhance the quality and cost effectiveness of the services their members receive.

ikaProHEDIS+ is a patent-pending Web-based application that combines analytic and workflow tools to enable proactive quality management. Health plans can analyze their quality status at any time for HEDIS® or other quality programs, with easy-to-run standard and ad hoc reports that draw on real-time or near-real-time data. Providers, care managers and members, in turn, gain access to current — not retrospective — information, allowing them to take action to improve patient care and collaborate more easily.

“Health plans are constantly on the lookout for tools that can help them improve HEDIS and other quality scores and streamline pay-for-performance programs,” said Ravi Ika, president of ikaSystems. “Ground-breakers such as Parkview and Passport recognize that superior results demand an entirely fresh technology approach, and that’s what ikaProHEDIS+ brings to the market.

“Enhancement of the HEDIS reporting process is only the start,” Ika continued. “ikaProHEDIS+ goes further than any competing industry solution, allowing health plans first to analyze where individual physicians stand right now on specific quality metrics, then helping them connect everyone involved in those metrics — primary care physicians, patients and health plan quality staff — in a collaborative community that improves the utility of the information as well as follow-through in acting upon it. Without making this fluid connection between information and action, health plans cannot achieve optimal results from their quality improvement and cost containment initiatives.”

Both Passport and Parkview were existing ikaSystems clients before deciding to move forward with ikaProHEDIS+, a component of ikaEnterprise, a single, integrated, Web-based technology platform that automates all health plan processes for commercial, Medicare and Medicaid lines of business. The modularity of ikaEnterprise’s service-oriented architecture (SOA) has two primary advantages.

• First, payers can easily implement individual pieces of the platform to quickly solve their most pressing business issues while developing their confidence and trust in ikaSystems as a technology partner. Payers can easily add modules as their needs evolve, building the strong and agile enterprise technology infrastructures that help improve quality of care and market responsiveness while reducing administrative, medical and information technology expenses.
  
• Second, SOA allows rapid deployment of a solution that specific to each health plan yet requires little to no custom programming, a “best of both worlds” scenario for ikaSystems clients.
  
  

Implementation began in October, and Parkview and Passport were both live with ikaProHEDIS+ on January 1, 2009.

For Passport, recognized four years in a row as one of the top 25 Medicaid health plans nationally, most recently ranked number nine by U.S. News & World Report and NCQA, partnership with ikaSystems began in 2000 with the use of the company’s utilization analytics, provider profiling and HEDIS reporting tools. With ikaProHEDIS+ and a second ikaEnterprise module, ikaP4P for pay-for-performance program management, the plan can enhance its well-established primary care provider quality recognition program. Passport’s provider community, which is heavily involved in creating the program, will receive more current quality information faster than ever before, helping them earn performance bonuses and clearly see the impact of incremental quality improvement on their payment. At the same time, the plan can achieve the highest possible quality scores while decreasing its administrative burden through the elimination of chart reviews.

“There was never a question regarding which vendor Passport Health Plan would select for enhancing its HEDIS scores. ikaSystems has been a long-term partner with our organization, with a proven track record for leveraging technology to maximize outcomes,” said DeDe Davis, vice president of operations at Passport Health Plan.

The Parkview-ikaSystems relationship was launched in 2006, with implementation of ikaClaims, ikaSystems’ highly configurable claims administration system. ikaPortals were added in 2007, and Parkview selected ikaSystems’ full suite of integrated medical management solutions, ikaMM, in 2008. ikaMM blends insight and workflow collaboration into a single, comprehensive and highly intelligent system to support and enhance all care management processes and programs: utilization, case and disease management, provider profiling and pay-for-performance (P4P), and quality monitoring and reporting. ikaMM provides a secure environment for payers, providers, care management staff and members to communicate and collaborate on the Web. Because all ikaMM modules draw upon a single, comprehensive data warehouse for financial and clinical analyses, everyone shares the same version of “the truth,” information that is updated in real time or near real time. ikaProHEDIS+ is the first module of ikaMM to go live at Parkview.

“Our interest in ikaProHEDIS+ centers around its ability to proactively and fairly measure quality and allow us share that information with the physicians in our network in a way that can truly affect the care our members receive. Ultimately, our goal is to keep our members at the healthiest possible levels,” said Philip Henneman, RN, director of HPS Clinical and Technical Operations.

About Parkview Health
Parkview Health is a not-for-profit, community-based health system that serves northeast Indiana, western Ohio and southern Michigan. Parkview is home to the region's only Verified Level II Adult and Pediatric Trauma Center. Additional services include the Samaritan Flight Program, Parkview Heart Institute, Orthopaedic Hospital, a Certified Stroke Center, Women's & Children's Hospital, Outpatient Services Center, and Comprehensive Cancer Center. Employing more than 6,000 full and part-time staff, Parkview Health’s mission is to provide quality health services and improve the health of the communities it serves.

About Passport Health Plan
University Health Care, Inc., dba Passport Health Plan, provides Medicaid managed care services for approximately 150,000 members in Jefferson and the 15 surrounding counties in Kentucky including Louisville. Passport Health Plan is sponsored by the University of Louisville Medical School Practice Association, University of Louisville Hospital, Jewish and St. Mary’s Healthcare, Norton Healthcare, and the Louisville/Jefferson County Primary Care Association, which includes the Jefferson County Health Department and Louisville's two federally qualified health centers, Family Health Centers and Park DuValle. University Health Care, Inc., contracts with AmeriHealth Mercy Health Plan for administrative services. AmeriHealth Mercy and its affiliates comprise the largest family of Medicaid managed care plans in the United States, touching the lives of over two million members nationwide. AmeriHealth Mercy specializes in providing management care services and management for publicly funded programs, with special expertise in Medicaid, Medicare and State Children’s Health Insurance Programs (SCHIP). For more information, please visit www.AmeriHealthMercy.com.

About ikaSystems Corp.
ikaSystems is healthcare payers’ premier provider of Web-based ERP technology for process automation and intelligence management. ikaEnterprise, the company’s flagship product, automates all key processes in the payer business cycle, supporting commercial, Medicare and Medicaid lines of business. The system consists of five stand-alone, self-service Web portals for sales/broker, administrative, employer, member and provider use, each of which are tightly integrated with business intelligence and transactional systems for core claims adjudication, care management and proactive quality measurement and reporting. Using our agile, modular technology, organizations can move quickly to lower administrative and medical care expenses through greater automation and highly intelligent decision-making. To learn more, please visit www.ikasystems.com.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).