Matrix Medical Network provides a comprehensive view of patient health to clients through health care assessments provided by a team of employee nurse practitioners. Matrix clients include health plan members in the nursing home, skilled nursing, and in-home settings. Matrix operates in fifteen states and has contracts with more than twenty-five health plans. The company helps health plan clients control costs by providing through specialized assessments and care for high-risk, chronically ill patients. Founded in 2001, Matrix now leads the industry as one of the first companies to provide prospective medical assessment services. Core to this success is the ability to efficiently collect member data and transform it into actionable information.
Challenge
Matrix works with health plans throughout the country providing comprehensive end-to-end medical assessment solutions through its Health Risk Assessment Program. The company was relying on a vendor for data storage and scoring to support the selection of health plan members that were eligible to participate in the program. Clients were also sending data in a variety of formats with varying data elements. This discontinuous data structure limited the company’s ability to maintain industry leadership through the creation of additional products that best serve health plan client needs.
Solution Deployed
Perficient was originally charged with designing, building, testing and delivering the first release of the Assessment and Clinical Enterprise System (ACES), a custom enterprise solution that addressed regulatory concerns for securing protected health information. Perficient leveraged the existing SSIS and SQL foundation software constructed as a part of the ACES solution to collect all member clinical data to help implement a more sophisticated member healthcare analysis solution. This is the first of several projects to better leverage member data to improve the effectiveness of the Health Risk Assessment process.
Business Value Delivered
- Enables Matrix to maintain industry leadership through the creation of new and innovative products
- Increased company ROI by streamlining the identification of members that can benefit from Health Risk Assessment Program services
- Increased the accuracy of coding and reporting client risk profiles
- Significantly improved the effectiveness of Health Risk Assessment Program processes
- Provided Matrix health plan clients with the ability to provide more efficient healthcare and improve reimbursement by Medicare