Performance Reporting and Analytics

Providers who accept the financial risks of value-based care want confidence that they can steadily enhance quality and reduce costs. This requires a systematic approach to care management that captures value at every stage of the process: identifying at-risk patients, engaging them and managing their care.

Follow your progress, see where your value-based care efforts are succeeding and discover where you need to adjust. As part of our continuous improvement cycle, we regularly analyze your performance data, offering scorecards, interim cost and quality forecasts and process improvement actions.

MHM Health’s provider partners rely on us to ensure that their Managed Care and Value-Based Care clinical and administrative operations are constantly improving

Our team analyze performance using standard measures, such as HEDIS, or custom measures our actionable improvement opportunities. Then we work with you to adjust care mode.

Provider Network Development

We support network physician’s development while limiting administrative overhead. Our strategies, tactics and tools help motivate physicians to embrace the opportunities in the IPA Managed Care and Value Based Care. We help strengthen and expand IPA provider network.

 We will analyze contracts, identify network requirements and provider performance, and work with you to develop a network to exceed the contractual requirements.

We provide:

  • Long-term partnership models
  • Actionable easy-to-understand score cards
  • Awareness, education, respect and relationships
  • Participation in leadership and governance
  • Develop cost-effective and competitive compensation
  • Rationalize incentives for providers delivering great Access, Quality, STAR Ratings
  • Provider contract negotiation, analysis and management
  • Network management and maintenance
  • IPA, physician and ancillary provider communications

Lines of Business Development

Obtain new health plan contracts all lines of business

Medicare Advantage

Regardless of your risk-taking goals to offload a portion of risk or taking on more risk, when it comes to Medicare risk taking MHM Health provides deep operating experience and capabilities for Medicare Advantage Plans and Medicare Advantage Delegated Risk

Provider-led Managed Medi-Cal IPA feasibility, launching and operating

Commercial and Self-Funded

We provide clinical, financial and administrative-services-only offerings to:

Health systems offering their own commercial health plans, Commercial payer partnerships

Strategic Business Development

  • Strategic and long-range planning
  • Board and leadership support
  • Community outreach strategies
  • Group positioning and marketing
  • Member acquisition, conversion and retention
  • Provider Managed Care and Value Based Care development

Next Generation Technology Fabric

Our mission is to help you be successful by providing high quality, cost-effective technology solutions, and business process re-engineering services across next generation capabilities. This offers you the ability to have your business hosted on a robust, scalable platform with no major capital or human resource investments. We remove this burden from you and allow you to concentrate on other critical business practices.

The MHM Health Tech Team are expert in Healthcare IT, selective software development, service integration from best of breed innovative components. We believe in sourcing HIPAA compliant outsourcing services.

A sample of the Premier Solutions we have woven into our service fabric:

  • VMWare – Virtualization Platform
  • VeloCloud – Software Defined WAN
  • Citrix Workspace – Remote Desktop
  • Netsapien – Secure VoIP Communication
  • Contivio – Unified Contact Center
  • Virtual Examiner – Claims Adjudication
  • IDM – Automated Fax Authorization
  • MD-Staff – Intelligent Credentialing
  • QuickCAP – Capitation Platform
  • EDDIE – HealthPlan EDI Inload