Medi-Code provides a cloud based infrastructure that not only satisfies the reporting requirements for the ACO or provider network but also analyzes health outcomes and quality measures for maximizing payer incentives and delivering better health.  The dashboards provide visibility into financial and operational data in order to control costs and increase savings while delivering Quality Care.

In addition to the 33 ACO quality measures and the patient cost predictive models, Medi-Code generates expenditure  and utilization reports using CCLF claims data automatically , which can be used to compare costs across the facilities and practices.  These are more detailed and useable than the ones mandated by CMS.

Medi-Code helps deliver contractual accountability to payers and provider network members

Provide performance and cost utilization information obtained from the claims data and process reports at each ACO and provider level to all the providers and facilities for decision making
• This information can help track the savings to be shared with different ACO members based on performance or contributions for shared savings metrics
• Visibility into patient population for member practices – including high risk patients – provides a mechanism to define separate contracts for each provider based on sharing of cost and high risk patient distribution

Data Analytics and Reporting

  • Dashboard and Analytics provide visibility to clinical, operational, financial and utilization measures.
  • Population management is key to developing risk profile of the patient population
  • Actionable information identify cost drivers – Hospital ADT data, ambulance use, ER visits, oxygen use, ancillary usage (MRI, CTI) etc.
  • Comparison of costs at individual provider level helps drive efficiencies

Medi-Code – Integrated, Real Time Cloud-based Platform Secure and HIPAA/ HITECH Compliant


Reporting is the first challenge most ACOs face.  Medi-Code can initiate reporting to CMS within 30 days.

  • Automatic GPRO XML generation for year-round or 8-week reporting
  • Reduce reporting activity from weeks to hours
  • Get rid of the reporting teams – just 1 or 2 people can perform the tasks quickly and easily
  • Support both individual practice reporting (PQRS) as well as aggregated group level  reporting
  • Allow flexibility of reporting as individual or group practice for different reporting periodsv

Real Time Data for Reporting

If the data is not real time, it’s neither accurate nor actionable. Other solutions report on the past data that cannot change present outcomes.  Medi-Code provides real time information that can assist with decisions affecting present medical outcomes and providing better care at lower costs.

Payer Reporting, Cost Savings and Incentive measurement

Using the data from various  sources, Medi-Code provides a better basis for risk adjustment than the traditional case-mix approach. This allows insurers a more accurate  method to develop reimbursement rates and quality incentives.