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HLCCompendium
HLCCompendium
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NDHI<br />
NAT IONAL DIALOGUE FOR<br />
Healthcare Innovation<br />
Care Improvement with<br />
Medicity ® Services<br />
Organization Overview<br />
• Aetna is committed to providing individuals, employers,<br />
health care professionals, producers and others<br />
with innovative benefits, products, and services<br />
• Medicity, an Aetna company, is a leading provider<br />
of network-enabled population health, connecting<br />
thousands of facilities through over 100 health information<br />
networks and processing 5 billion clinical<br />
transactions per year<br />
Background<br />
As healthcare organizations shift their focus to population<br />
health management, providers are becoming<br />
more responsible in overseeing the total spectrum<br />
of a patient’s care, regardless of where the patient<br />
chooses to receive his or her care. However, research<br />
shows that a large portion of patient care moves out<br />
of network, which hinders providers’ ability to improve<br />
outcomes and also increases costs.<br />
Medicity offers a range of health management solutions<br />
that are designed for the evolving healthcare landscape.<br />
These services improve data access and sharing<br />
across care settings, enable patient monitoring, and<br />
offer analytics for clinical and operational efficiency.<br />
Two products focused on improving care coordination<br />
and network utilization are:<br />
• SmartNetworks<br />
• CareTransitions<br />
Product Details<br />
SmartNetworks<br />
SmartNetworks is a robust web-based application that<br />
uses data analytics and powerful visualization to give<br />
providers insight into referral activities. With the analytic<br />
pathways offered by the application, providers can:<br />
• Track and monitor the causes of out-of-network<br />
care (“leakage”)<br />
• Understand which clinicians are sending patients<br />
out of network and where those patients are going<br />
• Identify opportunities to improve in-network care<br />
coordination, offer services, and reduce costs<br />
CareTransitions<br />
CareTransitions is a cloud-based tool that gives healthcare<br />
organizations a simple way to track, follow up, and<br />
improve on transitions in care. This is accomplished<br />
by integrating patients’ clinical data with longitudinal<br />
patient data about admissions, discharges, and transfers.<br />
Key features include:<br />
• Network Management & Smart Templates:<br />
Enables referral coordinators to create rules and<br />
preferences for network usage, in order to match<br />
patients with the right care providers<br />
An Initiative of the<br />
45 |<br />
Care Improvement with Medicity ® Services