Improve Health and Manage Risk

DxCloud: New Intelligence for Payers

Prognos DxCloud is an end-to-end solution to solve data connectivity, quality, and analytics needs. Prognos transforms lab data into actionable insights that allow payers to intelligently manage data and stores it within our AI analytic cloud. Flexible API’s and web services deliver lab results on-demand to payers, all within a HIPAA compliant infrastructure.

DxCloud supports enterprise use cases, such as risk sharing, care management, quality programs, risk management, data warehousing, and third party partner access.

Risk Alerts

Finding health risk in your member populations

Payers are challenged to identify health conditions in their members especially newly enrolled. Claims are an incomplete source of clinical conditions and payers need new timely clinical data sources. Prognos offers historic and ongoing near real-time clinical insights to optimize risk adjustment and better manage members. Prognos utilizes over 900 algorithms to interpret and identify conditions even for newly enrolled members. Risk Alerts runs on our industry leading platform DxCloud to flexibly deliver these insights.

Care Alerts

Identifying and tracking health conditions and disease in your member population

Payers are responsible for measuring and improving clinical quality of it’s members. Managing clinical quality requires timely and  clinically specific insights to inform member and provider outreach. Most payers rely on claims but it lacks timeliness and clinical insights. Prognos Care Alerts offers a historic and ongoing disease profile along with disease trajectory to clinically inform quality programs. Early detection of disease can improve HEDIS and Star scores significantly while facilitating better care and reducing medical costs.

Care Gaps

Finding health risk in your member populations

Payers strive to improve quality outcomes and member health. Payers require key documentation to close high value HEDIS / STARS gaps, however this documentation is often missing or inaccessible and not available in time to meet HEDIS reporting cutoff timelines.

The Prognos Care Gaps product is specifically designed accelerate the improvement of a Payer’s HEDIS scores through streamlined generation of supplemental data qualifier feeds. The product targets & locates hard to find member Lab Test Results and Test Dates to fulfill HEDIS Care Gap reporting requirements well in advance of HEDIS deadlines.

Prognos has achieved HITRUST CSF® Certification for its payer product portfolio featuring DxCloud, Risk Alerts, Care Alerts and Care Gaps.

Upcoming Conferences

RISE Nashville

March 17-19, 2019

In its 13th year, RISE Nashville features eight tracks and over 40 sessions, topics addressing existing and emerging industry issues including risk revenue management, quality improvement, member engagement and care management, payer-provider collaboration, new technologies and advanced analytics, and policy updates.  Prognos’ Frank Jackson presents day 2 on solving payer challenges with lab data and AI.  Schedule a meeting with us here!

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