Solutions Built with Purpose
We’re on a mission to advance value-based care. Our state-of-the-art solutions have been built with a laser-focused resolve to help you to tackle your greatest critical value-based care challenges.
What Challenges Are Payers Facing Today?
Improve risk and reduce the rate of increase in care. Nascate will give you the tools you need to act quickly through actionable data and insights.
Payer Challenge #1
Improve and optimize value-based payment arrangements
How We Do It
Understanding the relationships between providers and members, and the providers themselves, are critical for value-based programs to succeed.
Nascate quantifies these relationships to inform your decisions and actions at each stage of value-based care.
Improve Provider Alignment
By linking provider performance to relationship strength, we can identify the providers that are strongly connected to your members and optimally aligned with your interests, enabling you to:
- Increase transparency, clarity, and trust with your providers, align incentives and reduce friction, and achieve long-term stability
- Develop networks for growth and performance
- Optimize networks for value-based care outcomes and the Medicare Advantage Market
Improve Attribution
Assigning members to the right provider is a crucial part of risk-sharing agreements, but traditional attribution methodologies often fall short, leaving a large portion of the population out. This can result in missed growth and revenue opportunities, poor or misunderstood provider performance and even distrust.
By measuring provider-member interactions over time, we’re able to answer the all-important question of “ whose patient is this and which provider is accountable?”, enabling you to:
- Audit and improve existing methodology
- Assign a higher volume of members to capture missed growth opportunities
- Increase transparency and stability to improve provider trust
- Serve as a building block for attribution, risk, incentive sharing and contracting
Inform Value-Based Actions
By merging robust data sources with complex clinical and social information, Nascate can produce a holistic view of your population, as well as a complete 360-degree view of each member.
- With Nascate’s Member Profile you’ll get a comprehensive picture of each person that illustrates clinical information, social and treatment burden factors, risk and opportunity tags, gaps in HCC coding, provider relationship strength and attribution, utilization timeline and family information
- We also operationalize social determinants of health to micro-target value-based actions, match members to existing programs and community resources, anticipate risk and the need for early intervention
These timely and meaningful insights enable you to segment your population, match members to providers and programs based on their specific needs, prioritize actions, and tailor interventions—ultimately enabling you to clearly identify ways to change patient behavior
Improve Member Experience
Strengthening a member’s relationship to his or her main provider has a significant and measurable impact on that member’s healthcare experience. When a member is tightly connected to their main provider, we see a reduction in unnecessary services and visits, utilization is optimized, and that member can be retained.
Payer Challenge #2
Help health systems grow and retain members
How We Do It
A successful value strategy gives your providers the strategic means to improve performance, while also increasing revenue.
Nascate’s tools support growth and retention so you can support your providers and optimize partnerships in your value-based arrangements.
Measuring member-provider relationships to identify weak relationships and patients at risk of leaving, enables you to:
- Help your providers prioritize members at-risk of leaving
- Steer members toward high-performing providers
- Arm providers and provider groups with retention strategies
Measuring provider referral patterns and provider-to-provider connections, enables you to:
- Encourage participating providers to make in-network referrals
- Improve your network by adding new providers to cover gaps in physician specialties or geographic areas with limited options—or those out-of-network physicians who often receive referrals
Payer Challenge #3
Consolidate relationships around high-performing providers
How We Do It
Nascate’s ability to truly understand provider performance and influence enables you to identify high-performing providers and organizations, and consolidate member services around those providers.
By guiding members to high-performing providers, you will be able to:
- Control utilization and reduce overall total cost of care for the network
- Reduce ED visits, inpatient stays, and readmissions
- Reduce leakage to better manage utilization and control cost
- Improve care density and optimize care teams to manage cost
- Improve retention with stronger relationships that help long-term savings
AND MORE, INCLUDING:
- Recognizing weak relationships so as to improve member experience and care, lower costs, and improve retention
- Identifying merging high-needs members including details on the clinical and social needs that are placing them at-risk
- Pinpointing patients that should be targeted for intervention earlier in the year
Overcome Existing Challenges and Evolve Your Value-Based Care Model
Nascate provides meaningful analytics that augment existing capabilities to overcome current challenges and evolve your value-based care model.
New opportunities in value-based care recognize the primary care provider’s role in managing a person’s health and the overall value-based performance.
New challenges come from the increasing need to manage and coordinate the care of individuals, families, and populations across the multiple contracts and incentive structures.
ACTIONABLE INSIGHTS BASED ON:
- Patient-to-provider relationships
- Provider-to-provider relationships
- Consumer behavior and decisions drivers that contribute to leakage
- Utilization patterns and provider referral patterns that contribute to leakage and churn
- A patient’s 360-degree profile, made up of a range of social determinants with data points accrued over time, such as geography, family support, connections, behavior, access to health care, and more