Populytics, Inc. has been awarded the highest (three-year) Accreditation in Case Management by the National Committee for Quality Assurance (NCQA). The award is a timely recognition: Populytics Care (Case) Management works with care providers and insurance payers to ensure patients receive the critical care and support they need in an environment increasingly challenged by intersecting requirements.

“COVID-19 has compounded the challenges to keeping patients and clinicians connected and on track with their health care,” says Nina Taggart, MA, MD, MBA, FAAO, Senior Medical Director of Accountable Care, who oversees Populytics Care Management in partnership with Jonathan Burke, DO, CHCQM, Medical Director, Clinical Services. “The Populytics team relies on Populytics analytics and provider clinical workflow systems such as LVHN’s nationally recognized Epic installation to promote quality outcomes and support personal goals of care for our patients. This Accreditation is a wonderful recognition of the quality improvement at the core of that work.”

NCQA awards the status of “Accredited–3 years” to organizations that demonstrate strong performance of the functions outlined in the standards for Case Management accreditation. NCQA Accreditation standards are developed with input from researchers in the field; the Case Management Expert Panel and standing committees; employers, both purchasers and operators of Case Management programs; state and federal regulators; and other experts. Accreditation standards are purposely set high to encourage organizations to continuously enhance their quality.

Care management at Populytics is a collaborative effort consisting of assessment, planning, care coordination, facilitation, and advocacy. “Two teams strive to ensure optimum health plan utilization, and to connect patients with programs and services that promote healing and recovery via medical, behavioral health, and social channels – all while promoting quality and cost-effective outcomes,” says Carol Michaels, MPH, MCHES®, Administrator, Care Coordination. There is an emphasis on patients who are at a high risk for costly hospitalizations as a result of serious social, behavioral or medical needs. Michaels notes that in Populytics’ integrated approach, care coordinators follow through with personal outreach to patients in collaboration with health centers, partner hospitals, and community services.

“Case Management Accreditation moves us closer to measuring quality across population health management initiatives,” says Margaret E. O’Kane, President, NCQA. “Not only does it add value to existing quality improvement efforts; it also demonstrates an organization’s commitment to the highest degree of improving the quality of their patients’ care.”

For more information about Populytics’ care management services, reach us here.

Populytics, Inc., a wholly owned subsidiary of Lehigh Valley Health Network (LVHN), is a population health management and advanced analytics firm that facilitates the movement toward value-based care. Through our advanced analytics toolkit, we transform health insurance claims and clinical data into actionable information for constituents such as hospitals and health systems, physicians and other clinicians, as well as employers, and the region at large. Our services include population health analytics, health benefits administration and consulting, and clinical care coordination. Populytics’ services afford higher quality care while bending the cost curve. As an added benefit to regional businesses during COVID-19, Populytics has consolidated LVHN’s employer health care resources into a comprehensive return to work portfolio. Offerings range from diagnostic/antibody testing and counseling for stress management, to long-term well-being programs. Learn more here.

NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more-informed health care choices. NCQA can be found online at ncqa.org, on Twitter @ncqa, on Facebook at facebook.com/NCQA.org/ and on LinkedIn at linkedin.com/company/ncqa.