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Enhance Revenues, Contain Costs and Improve Quality

As health plans moved from a volume-based to a value-based model of purchasing, it created the need for greater practice management, administrative support, and strategic support services. To adapt to this market shift, hospitals, health systems and physicians are collaborating—forming management services organizations (MSOs)—to develop more clinically integrated networks.

Inovaare understands the challenges that MSOs face, especially when it comes to implementing effective risk-based payment models. Inovaare’s compliance and automation solution for MSOs allow them to customize configurations of fee-for-service or capitation payment models.

Through this integrated and scalable platform, MSOs experience:

  • Superior collaborative provider networks
  • Lower operational costs
  • Proactive care management deployment
  • Automated workflows that improve quality care delivery
  • Reduced utilization costs

Key Benefits

  • Mitigated compliance risk through transparent, centralized premium and claim data
  • Timely fraud, waste and abuse detection
  • Audit content management without IT support requirement
  • Comprehensive platform to manage and track oversight functions for first-tier, downstream and related delegated entities
  • High-dollar claims monitoring and management
  • Online training module and an attestation process to comply with the CMS FWA requirement

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