Dive Brief:
- The UPMC healthcare system has made a "significant investment" in Health Fidelity, a company that creates technologies to aid value-based care. The company says it will use the cash to expand research and development, strengthen its team and increase its market share.
- The Health Fidelity risk adjustment solution was deployed at UPMC Health Plan last year and is credited with enhancing operational efficiency and compliance management.
- The companies state that UPMC saw value in using a comprehensive risk adjustment solution for Medicare Advantage, Medicare ACO and health insurance exchange programs. As a result, it partnered with Health Fidelity in 2014 to assist in the completion of the technology.
Dive Insight:
As Health Fidelity notes, the ongoing shift from a fee-for-service to a value-based business model is pushing healthcare organizations to optimize risk adjustment operations and improve compliance.
Now, through UPMC's investment, the company aims to accelerate its risk adjustment and other value-based care solutions to the market to help health plans and health systems.
Health Fidelity states that today, most organizations are harnessing only 20% to 30% of available clinical information when making population management decisions.
"By collaborating with the clinical and technology experts at UPMC, Health Fidelity is able to offer the most comprehensive, scalable solution on the market for perfecting the risk adjustment cycle," said Mary Beth Jenkins, Senior Vice President and Chief Operating Officer, UPMC Health Plan and UPMC WorkPartners, in a prepared statement. "It's an innovative technology that has delivered measurable results to UPMC Health Plan, seamlessly integrating with existing risk adjustment processes to deliver results while improving compliance and process efficiencies."