MEDecision, Inc., a leading provider of collaborative healthcare management solutions, today announced the general availability of Alineo® 3.0, the latest version of its Alineo collaborative healthcare management platform.
What is Alineo? Alineo is a collaborative healthcare management platform for delivering outcome-driven case, disease and utilization management. It provides a comprehensive view of past and present clinical data for patients and patient populations. Alineo is designed to help health plans increase the overall quality, affordability and efficiency of care. It helps maintain costs and improve outcomes by fostering greater clinical consistency, streamlining operations and bolstering workforce responsiveness.
Why is Alineo important? During this time of health reform, the greatest challenge for the healthcare industry is achieving better patient outcomes while making healthcare more affordable. Deployed effectively, Alineo supports collaborative care management between health plans, providers and patients. This is one area that can help with health reform compliance, reduce costs and improve care.
Who will benefit? Health plans faced with the challenge of meeting the mandates of healthcare reform, patients who want better care at lower cost, and providers who need access to information from throughout the healthcare ecosystem in order to provide the best possible care.
What new features are available with Alineo 3.0?
- Behavioral Health – Alineo 3.0 offers a new behavioral health utilization module designed to support compliance with the 2008 Federal Mental Health Parity and Addiction Equity Act. All care requests and programs can now be designated as medical or behavioral health related. Alineo incorporates standard DSM 5-axis coding to better classify patients. Integrating this with medical and surgical information allows for more holistic patient management and care.
- Auto Workflow and Auto Approval Enhancements – The expanded rules and approval functionality within Alineo 3.0 reduces the administrative costs associated with rule maintenance and, at the same time, allows health plans the ability to more easily create complex rules that are required to manage their business.
- Multiple Active Enrollments – A health plan member may have multiple insurance carriers, with the same or different subscribers, with overlapping eligibility dates. Alineo 3.0 now captures primary and secondary coverage information for members, providing a complete view of all member healthcare coverage and associated enrollment.
- Outcome Text Field – Alineo 3.0 now provides a model field designed to capture rationale for utilization management outcome decisions. This feature supports health plans’ critical need to capture and communicate detailed information regarding care decisions and also helps them meet state and accreditation standards.
- Program Providers – With Alineo 3.0 health plans can associate multiple providers with a program, enabling them to better track and coordinate the plan of care between the patient, provider and payer.
- Clinical Criteria – Alineo 3.0 offers health plans the option of using both Milliman Care Guidelines® CareWebQI® version 2.0, 14th edition; and CareEnhance® Review Manager 9.0, InterQual® 2010 clinical criteria for utilization management requests. Alineo’s interoperability with these best-of-breed clinical criteria vendors supports health plans’ ability to make consistent utilization management decisions for both medical and behavioral healthcare.
- Microsoft® SQL Server® Enterprise Platform Support – Organizations will have the option to operate Alineo on the Microsoft® SQL Server® Enterprise platform later in the year. [Read more…]