Population Health Management for Medicare Advantage
Industry’s Premier Solution Set for Medicare Advantage Programs
Key Concepts for Population Health Management with Medicare Advantage
ZeOmega has over two decades of experience working with payers and other risk-bearing entities to drive government program success. We know what it takes to stay in compliance while supporting optimal care for complex patient populations and continuously monitoring and managing cost and efficiency.
When it comes to Medicare Advantage programs, you simply cannot cut corners. We have built a comprehensive Medicare Advantage solution that covers all compliance requirements, automating adherence to complex reporting and regulatory obligations.
Star Ratings and compliance metrics depend on your teams having the intelligent tools and insights to zero in on the gaps and opportunities with the biggest impact while holistically addressing individual member needs. Powered by the most superior clinical content in the industry, we automate proven best practices with “next best action” workflows, enabling your teams to focus for maximum impact and ensure consistent quality for every member.
ZeOmega Medicare Advantage solutions feature built-in Risk Adjustment, drive consistent success in PMPM payment models, and maximize HEDIS® bonus performance. Whether you are seeking to grow your Medicare Advantage membership, improve transactional efficiency, or take your UM and CM performance to the next level, we have you covered.
Key Solutions for Medicare Advantage
Jiva Healthcare Enterprise Management Platform
Your one-stop shop for a comprehensive set of practical, AI-powered solutions to today’s—and tomorrow’s—challenges. Empower your teams to accurately administer benefits, manage the organization, and profitably run the business for the best outcomes for everyone.
HealthUnity™ Data Interoperability
Apply analytics to transactions to indicate potential care gaps or identify member populations/providers who should receive specific updates—all while supplying enriched data feeds to other payers and facilitating greater continuity.
HealthUnity™ Smart Authorization Gateway, our ePA solution
A powerful, FHIR-based interoperability gateway that facilitates payer compliance with the Patient Access API, Provider Directory API, Payer-to-Payer Data Exchange requirements of the Final Rule, and more.
SDOH Social Care Platform
This groundbreaking platform aggregates data from a wide variety of government, claims, and assessment sources to provide accurate indications of social risk at a community and personal level.
Jiva Care Quality Navigator
A forward-thinking performance monitoring and analytical solution with an embedded omnichannel workflow that centralizes HEDIS and CMS Stars quality program data, improves care gap closure rates, and empowers value-based care reporting.
Care, Disease, and Utilization Management
Whether you are pursuing broad-based population health initiatives, focusing on a handful of specific disease states, or refining your approach to utilization management, the care management capabilities in Jiva drive workflow efficiency, quality, and cost savings.
ZeOmega is #1 Best in KLAS for Payer Management Solutions 2022 and 2023
Impact of the New CMS Healthcare Interoperability Rules | ZeOmega
Much of the direction of the 2020 proposed rule is in the new proposed rule, particularly the sharing of prior authorization decisions/status with patients.
AbsoluteCare Selects ZeOmega for Chronic Care Management for High-Risk Patient Populations
ZeOmega announced today that value-based integrated healthcare provider AbsoluteCare has selected ZeOmega’s Jiva platform to fulfill its needs for comprehensive care management, utilization management, and clinical assessment support.