Beth Zuehlke
If I had to sum up my overarching goal for working with our existing and future customers in 2023, I’d say it would be to help them provide better data, faster. By better, I mean high quality, comprehensive data that is meaningful, timely, and actionable.
Anyone whose work relies on the exchange of healthcare data knows that in today’s climate, sending and receiving the right data at the right time in the right format, all while maintaining stringent patient privacy and security standards, is critical. As more providers and payers enter into risk-sharing agreements, there is a need to share even more data.
With a growing Medicare Advantage population, for example, CMS is asking payers for less extrapolation of data and more of the real deal. In 2022, nearly half of the eligible Medicare population was enrolled in a Medicare Advantage plan. More than half of federal Medicare spending—$427 billion—was on Medicare Advantage plans.
As our CEO Dan noted in his recent blog, we need to increasingly use clinical data, not claims-based data, to run the business of healthcare. While using clinical data to support value-based care is ideal, it can put more of a strain on already resource-stressed healthcare and payer organizations.
Enter Moxe. Our 100% digital solution automates clinical data acquisition, which enables payers to access more accurate and complete data quickly and cost effectively in the format that works best for them. PDF, XML, JSON, and FHIR are just some of the ways we can deliver data. We make the exchange of clinical data easy, secure, and impactful. This year, we’ll continue to work with our customers to determine how we can best package data to enable them to efficiently run their business.
I am privileged to partner with customers who understand that in a world where the demand for more and better data is ever-increasing, they have to work smarter, not harder.
Recent success stories
Riverside, a hospital system with 700 providers across four acute care hospitals and three specialty hospitals, is one of our customers who uses Moxe to relieve the burden of an increasing volume of ROI requests.
Before working with Moxe, Riverside had tried a mix of models–insource, outsource, and hybrid–to support their ROI process.
Despite their best efforts, meeting payer deadlines was becoming more and more difficult.
They implemented Moxe’s Digital ROI and were able to automate 50,000 quality improvement, provider payment integrity, and risk adjustment audits in 2021. While they started with just two requestors, they added an additional 10 once they saw the return on their initial investment.
Riverside’s HIM Compliance Manager, Angela Dust, said, “Moxe is seamless. Because Moxe works with many of our largest requestors, we reduce the manual burden on my team, fulfill large volumes of requests quickly, and deliver the payers the accurate clinical data they need within their deadlines.”
Similarly, Atrium Health struggled to keep up with their large volume of chart requests, especially during HEDIS® and Medicare Risk Adjustment (MRA) seasons.
On average, their call center was fielding 5,000 calls a week, with about 500 related to HEDIS and MRA.
They wanted to focus on patient requests, not audits, so they implemented Moxe’s Digital ROI to automate the HEDIS and MRA requests from two of their largest payers, representing about 70,000 requests annually.
In doing so, Atrium reports they have been able to save 3,500 hours in manual chart retrieval and eliminate 26,000 phone calls.
Atrium’s HIM Director, Hannah Sorgius, says, “By automating chart requests for HEDIS and MRA, Moxe helped us save time, reduce costs, and regain our focus on patient care.”
For one large national Health Plan, they were looking for a fully automated solution which would allow them to maximize revenue through high quality claims data.
Using Moxe’s 100% digital solution, the Plan was able to automate chart retrieval across some of their largest provider networks, regardless of EHR. With a delivery rate of 93%, the Plan was able to address gaps in care sooner and manage risk.
Now live with more than 45 health systems, the Plan has benefited from streamlined processes around clinical data acquisition.
“It’s not just about saving money. Automating chart retrieval makes us money by helping to close care gaps and get those risk adjusted conditions documented appropriately,” shared a leader at the Plan.
Regaining the focus on patient care
To me, that’s what working at Moxe is all about: Helping customers regain the focus on patient care. Kudos to our customers for the work they are doing to put patients first and to be collaborative, cost-effective, and creative players in the healthcare ecosystem.
I am looking forward to continuing my work with our existing customers and getting to collaborate with new customers in 2023.