PayersHealth plans and other payers are confronting a growing need to manage risk more effectively and obtain greater value for every healthcare dollar. Our resources and proven experience help payers coordinate with providers and employers to find the right balance of risk and outcome-based value.
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Conduct prospective and retrospective analysis of adjudicated claims data by facility, provider, payer, procedure, and disease state. Identify actionable opportunities to reduce costs and improve performance in value-based contracts.
Analyze healthcare data from both a clinical and financial perspective. Access industry standard reports, designed both for the casual user and the power user, that focus on utilization and cost for areas including location of service, diagnoses, procedures, providers, and drugs.
Outsource prospective or retrospective bundled payment programs to Cedar Gate. We will take-over the entire management process from start to finish, including network development, payer contracting, provider credentialing, contract design, performance reporting, and payment distribution.
Leverage a care management platform designed specifically for clinicians and healthcare professionals that assist health plan members and their families. Oversee care management activities that focused on wellness, disease management, case management, and utilization management, all from a single integrated platform. In addition, a provider portal offers an integrated pathway to request service and pharmacy authorizations, and to review historical member information. Engage members through a dedicated health portal that supports personalized care gap notifications, health goals, health risk assessments, and incentive management.
Our technology enables government, commercial and private health plans to design, build, deploy, and analyze clinical and financial performance for defined populations. Health plans utilizing our platform are better prepared to respond to population health dynamics, to moderate their risk profile, while sustaining high-quality customer service.
Our solutions make operating all aspects of managed care services simple for Independent Physician Associations (IPAs), TPAs, health plans, and PACE clients. With a single, powerful platform, you can manage all providers and members across multiple companies, lines of business, and contracts. The system will scale with your business as it grows, enabling you to manage hundreds of customers, and millions of members.
Act on emerging opportunities to transform operations and improve financial performance.
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A large commercial payer with multiple clinically integrated networks engaged Cedar Gate to identify targeted opportunities…
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Developed by Dr. Martin Makary, the appropriate care measures identify clinical variations at the physician-level…
READ MORECedar Gate Technologies Named in Gartner’s Hype Cycle for U.S. Healthcare Payers, 2020
READ MORECedar Gate’s analytic and bundled payment systems support payer-provider collaboration, so patients have greater access to affordable, quality care.
READ MORECedar Gate’s enterprise performance management analytics and administration platforms reduce risk, enhance financial performance, and improve patient outcomes for healthcare organizations across the value-based care continuum.
Capture, organize, and utilize all valuable data sets securely and easily.
EXPLOREEmpower your team with timely information to take action and reach performance goals.
EXPLORETransform the way you report on your business with these intelligent tool sets.
EXPLORESupport medical management activities across the care continuum.
EXPLOREManage patients effectively from chronic conditions to transitions of care.
EXPLOREAdminister retrospective and prospective bundled payment arrangements with clinical excellence.
EXPLOREOperate multiple lines of business with claims and benefits administration, eligibility, capitation reconciliation, financial management and more.
EXPLOREExtend your effectiveness with managed, professional, or advisory services.
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