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Health Compliance & Risk Management

It is important for all providers in the healthcare ecosystem to have a fundamental shift from delivering episodic care to establishing longitudinal engagement with the patients. Having a strategy to attract and better serve high-need patients will be very important for the hospitals to ensure sustainable growth in uncertain times. It is important for health insurance companies and employer groups to have information on the evolving disease severity index of their policyholders/employees so as to effectively manage their health.

HEAPS’s Health Compliance & Risk Management platform helps multiple stakeholders in the healthcare ecosystem to proactively engage with their patient population, especially the high-need patients, thereby empowering healthcare providers with actionable insights to take the right intervention for the right set of patients at the right time.

The primary goal is to minimize avoidable hospitalisations for payers and drive more case mix and revenue to the providers. It continuously tracks and monitors patients with underlying medical conditions throughout the year to ensure disease progression is within acceptable clinical limits.

  • Key Features
    • NLP algorithms to auto-read and structure medical records
    • Calculation of Disease Severity Index which measures the amount of healthcare resource consumption by the patient
    • Upgrades or downgrades risk levels based on clinical guidelines and patient inputs
  • Benefits to Hospitals/Providers
    • Increased occupancy rates
    • Increased average revenue per bed through increased case-mix
    • Decreased operational expenses
    • Reduced patient leakages
    • Increased patient loyalty and satisfaction
    • Improved compliance to labs, medications and regular checkups resulting in controlled disease severity
    • Sense of security that their timely care will be provided
    • Support for ancillary medical needs
    • Lower the incidence rate of hospitalization
    • Estimating disease severity for employee and dependence in real time for preventive care management
    • Improved employee productivity
    • Increased employee satisfaction
    • Lower incidence rate of hospitalization
    • Reduced average cost of hospitalization
    • Lower incidence rate of repeated hospitalization
    • Improved drug efficiency through real world evidence
    • Capture drug-drug interactions on patients
    • Increased adherence rate leading to higher revenue
    • Increased customer satisfaction and loyalty
    • Improved patient compliance rate
    • Improved patient loyalty and customer satisfaction