Nemours Children’s Health seeks to transform the health of children by adopting a holistic health model that utilizes innovative, safe, high-quality care while also caring for the health of the whole child beyond medicine. Nemours also powers the world’s most-visited website for information on the health of children and teens, Nemours KidsHealth.org.
This session explores Nemours strategy to integrate multiple data sources using the roster management engine within Epic. This approach led to numerous positive outcomes, including improved patient access to primary care and performance on primary care value-based contracts. From an operational standpoint, this allowed Nemours to streamline workflows, remedy internal process gaps and achieve a high success rate in payer appeals, ultimately leading to increased revenue and investments in primary care. Nemours' experience provides a scalable model for other health care organizations pursuing the value-based health care journey.
What You Will Learn:
- How crosswalks are developed between Nemours Medical Record Numbers (MRN), payer subscriber numbers, and other providers' MRNs
- How Nemours provides primary care providers within its system and its clinically integrated network of community providers (non-Nemours, Non-Epic) the ability to assess their performance against the quality metrics of various payers
- How Nemours develops tailored campaigns and strategies designed to close identified gaps in care with these insights