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Health Plans - Overview

Market changes in recent years, including new shared-risk models (ACO, bundled payments) and emerging regulatory requirements (Meaningful Use, HEDIS) have resulted in significant need to enhance technologies for health plans and payer organizations. Health plans today need to collaborate with provider organizations and effectively leverage both clinical and financial information to address these challenges.

As a global leader in healthcare technology, CitiusTech has deep expertise in clinical data and related technologies - EHR, HIS, healthcare information exchanges (HIE), medical imaging, ancillary systems (labs, pharmacy) and other clinical systems. In addition, our expertise in health plans and managed care workflows enable us to provide specialized technology solutions to health plans.

With specific focus on payer-provider collaboration, CitiusTech has extensive capabilities in population health analytics, consumer health, care coordination, clinical quality measurement and benchmarking. CitiusTech's suite of offerings for health plans include:

Payer-Provider Data Integration: Aggregation, mapping and standardization of payer and provider data, across multiple operational, financial and clinical systems.

Clinical Quality and Benchmarking: Scorecards and dashboards for tracking clinical quality measures, and benchmarking physician and provider performance against regulatory requirements like HEDIS, P4P, ACO-33, etc. With over 600 pre-built measures, CitiusTech's BI-Clinical platform offers substantial out-of-the box capabilities for clinical quality reporting.

Population Health Analytics: Packaged or custom solutions for population health management - such as population viewer, patient risk profiling, disease registries and evidence-based protocols. BI-Clinical’s Rules Engine can be effectively leveraged for rapid development of population health solutions.

Consumer Engagement: Next-generation patient and provider engagement solutions using web, mobile and social platforms - to increase outreach, enhance patient self-management and improve care outcomes.

Please explore our health plans and managed care case studies section for further knowledge. To learn more, please contact us by email at or call us at +1 (877) CITIUS1.
Case Studies
Brochure: BI-Clinical: Advanced BI & Analytics for Health Plans
Brochure: CitiusTech Health Plans Practice
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