ASTUTE
Philosophy
medASTUTE was founded on 6 guiding principles.
Healthcare is in our DNA
We have a deep understanding of the “payer-provider continuum” having worked in and/or consulted for some of the largest health organizations in the country.
Our expertise spans operations, finance, IT, and data.
Most of all, we ourselves are consumers who can empathize with the average person who has the unfortunate & daunting task of navigating a complex and expensive healthcare system.
Meet the Leadership Team
Lance De Peralta
Co-Founder & Chief Marketing Officer
Vanessa Griggley-Owens, MBA, RHIA, CHC
Co-Founder & Chief Compliance/Privacy Officer
Daniel Sherer
Co-Founder & Chief Technology Officer
Pam Hess, DBA, MA, RHIA, CDIP, CCS, CPC
Vice President of Strategy & Operations
Advisors
Terry Fouts, MD
Transcarent
Henrietta Comrie, RHIT, CCS, CPCO, CCDS, CPC, CRC
AHIMA Approved ICD-10 CM/PCS Trainer
Partners
"Give a man a fish...feed him for a day"
Your data is full of potential (opportunities) – we can help unleash them…with analytics!
Our team lives and breathes analytics – it’s the “A” in medASTUTE after all. It’s our bread-and-butter.
Perform analytics:
Our experience has shown that conducting an in-depth analysis on a variety of healthcare topics, leveraging a client’s data & technology assets, yields many growth & improvement opportunities.
Analytical Insights
- Analyze medical & pharmacy claims data to identify healthcare cost "drivers" - i.e., the root causes of the use of certain services & their associated costs.
- Recommend ways to reduce cost while maintaining / improving patient care.
- Document our findings, recommendations, and quantified savings opportunities in a comprehensive report - the Opportunity Assessment - and present it to key stakeholders.
Actionable Insights Plan
- Support the implementation & monitoring of recommended course(s) of action detailed in the Opportunity Assessment.
- Develop action-driven plans that align with organizational goals.
- Implement tools & measures to track progress and accountability.
Spotlight
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"Teach a man to fish...feed him for a lifetime"
But as much as we enjoy “giving” a client valuable data insights & tangible opportunities to save money etc., there is no greater feeling than “teaching” that client to “fish” for those same kind of opportunities – to invite & embrace a culture of analytics and data-driven, decision-making.
Implement analytics:
Independent project oversight & subject matter expertise can minimize risk and increase success.
Gap Analysis
- Understanding your organization is our goal, first and foremost. We'll review your existing business operations, processes, and needs.
- Document your current and intended future states.
- Vendor evaluation: Does the vendor's analytics solution check off all (or most of) the boxes?
Business Requirements Review
- Ensure your business needs are accurately translated into technical specifications.
- Review files, reports, and data elements to make sure you get what you need out of the implementation the first time around.
Technical Specifications Review
Conduct a thorough review of all data mappings and specifications before the vendor builds your analytics solution.
Test Plan Development & Execution
- Design a detailed test plan, complete with nuanced scenarios, client-specific uses cases, and test methodology for broad organization-wide buy-in.
- Help you execute the test plan. Provide additional resources (pair of extra hands or an entire team) to get you past this critical implementation phase.
Adopt analytics:
Improve the adoption process and reduce the time-to-value for your staff.
Roll-Out Strategy Development
- Design a rollout strategy that integrates your analytics solution (and its intended changes) into your staff's day-to-day responsibilities.
- Marketing/communication plan
- Rollout timeline
- Socialization; identify key champions within your organization
Roll-out Execution & Change Management
- Be the "boots-on-the-ground" to ensure your staff has everything it needs for a smooth transition.
- Train staff on how to think analytically to answer specific healthcare questions affecting our business.
- Introduce "Prescription for Analytics" - a training method developed by our advisor & dear friend, Dr. Fouts.
- Ongoing training as needed.
Spotlight
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Healthcare Consumerism
It's been around for years...
An individual playing an active role in purchasing and consuming healthcare services – that’s healthcare consumerism in a nutshell.
It continues to grow and evolve – with plenty of room for improvement!
COVID-19 brought about an extraordinary change in healthcare consumerism.
For instance, telehealth & other forms of “virtual care” exploded onto the scene even though (technically) they have existed long before the pandemic. New start-ups & technologies, coupled with a growing acceptance from insurers, providers & patients, have made telehealth an industry mainstay.
In our view, successful healthcare consumerism is the convergence of literacy and transparency.
Literacy
- Provide consumers a wealth of valuable information, along with timely & practical education, about our industry.
- Consumers will learn key terms & concepts from health plan & provider “insiders” to gain the confidence to use this knowledge to manage their out-of-pocket costs and improve their health.
Transparency
- Put pricing & quality information into the hands of the consumer to make more informed care decisions.
- Help consumers search for the best providers (quality) at a fair price (cost) for “shoppable” services (choice).
Practice Transformation
Credentialed provider experts at your service!
Our team is credentialed in:
- Clinical documentation
- Coding
- Compliance
- Healthcare finance
- Reimbursement
In addition, our VP of Strategy & Operations (Dr. Pam Hess) is a leading authority on clinical documentation, reimbursement and revenue cycle challenges.
Dr. Hess has authored two books:
- Clinical Documentation Improvement for Outpatient Care: Design and Implementation
- Clinical Documentation Improvement: Principles and Practice
In 2019, she was invited to speak at the AHIMA World Congress Healthcare Information Summit in Abu Dhabi, UAE.
In these unprecedented times, parlay our team’s provider experience into your organization’s success.
Risk, Strategy & Operations Consulting
- Review your daily operations, identify areas of improvement, and put in place tools & systems to implement & monitor recommended solutions.
- Provide resources to support initiatives critical to your success (e.g. software implementations & conversions).
- Optimize and leverage your data & technology to support contract negotiations with payers and ensure you're not "leaving money on the table" that you're legally entitled to.
- Assist providers to develop an effective denials management program including root cause and solutions for high impact denial categories.
- Provide staff the necessary education & skills to run an effective and efficient organization.
Partners are clients too!
“Partner-clients” don’t need to spend time, money & resources developing a new (or growing an existing) product / business / service line that fall outside of their expertise or business model.
Instead, they have access to our services & expertise that can help open up new business opportunities or strengthen existing client relationships.
Best of all – the partnership is reciprocal!
Business Gaps
medASTUTE offers a service or product that a partner (or its client) needs. Examples include:
- Staff augmentation
- Sales retention, support & expansion using analytics
RFPs
Strength in numbers; medASTUTE plays the role of subcontractor or joint consulting partner.
Pilots & Proof-of-Concepts
"Low-hanging fruit" opportunities requiring minimal investment.
Other Collaborative Ventures
Examples include:
- Co-marketing & co-branding
- Referral & partner programs
Contact us today!
