Brooks Corbin, CEOThe enactment of the Medicare Modernization Act of 2003 (MMA) was a game changer in the healthcare arena. It brought about a tectonic shift in the compensation policies framed for serving chronically ill patients. Amid these circumstances, Brooks Corbin and a group of others perceived an opportunity to enable health plans to better manage the new pay algorithms created by MMA in regards to Hierarchical Condition Coding (HCC). While the intricacies in government-sponsored healthcare have grown exponentially over the years, Dynamic has been assuaging the situation effectively for its clients. The Irvine, CA based Dynamic empowers clients to overcome a spate of challenges that range from consolidation of member data to integration of vendor systems and databases.
Dynamic provides an integrated, end-to-end suite of Software-as-a-Service solutions that utilize a centralized database and enables health plans to work with one system and vendor while eliminating departmental silos. “Health plans can mine the rich set of member data from the centralized database and identify gaps in care—improving the quality of care for their members,” says Dynamic’s Chief Executive Officer, Brooks Corbin. The consolidated data simplifies data mining for the health plans and expedites the decision-making process. “Our system applies advanced algorithms against that data to yield actionable results,” states Jim Corbett, Dynamic’s Chief Strategy Officer, and Co-Founder.
Along with facilitating the identification of potential gaps in care, Dynamic’s algorithms also highlight provider coding underperformance, forecast financial data including individual member risk scores, and facilitate the reconciliation of Medicare Advantage Risk Adjustment Processing System (RAPS) and Encounter Data Processing System (EDPS) risk scores. The results can be generated and incorporated into Electronic Medical Record (EMR) systems for presenting to the provider within 24 hours of the patient’s visit. Dynamic’s Hierarchical Condition Category (HCC) Analytics solution identifies discrepancies in the encounter data and the two risk scores, enabling health plans to understand the root cause of issues and quickly address them, resulting in accurate payments from CMS.
Dynamic is able to assimilate disparate data through its proprietary analytics to generate useful findings which empower healthcare organizations
In one of the implementation highlights, a California-based major health system that shares Medicare Advantage risk with several major health plans sought a solution to improve the quality of care and ensure proper risk-based CMS payments. Historically, it used to take around 90 days for the health system to receive information from the health plans related to possible coding challenges and care gaps, and the data was provided in static reports. By adopting Dynamic’s HCC Analytics solution, the health system was able to significantly shorten the timeframe and migrate from static reports to a comprehensive analytics platform.
In its pursuit to help all stakeholders in the healthcare arena, Dynamic also provides an enrollment system for ascertaining every member’s eligibility and enrolling members in Medicare Advantage plans. The system utilizes CMS Batch Eligibility Query (BEQ) process for automating eligibility verification and flagging members with eligibility issues.
Dynamic is currently working on modernizing and advancing the capabilities of its Medicare Advantage solution’s User Interface (UI). “We have subject matter experts for every Medicare Advantage module who collaborate with clients to identify functionality and product enhancements that will be beneficial for them,” states Corbin. “At the end of the day, Dynamic is able to assimilate disparate data through its proprietary analytics to generate useful findings which empower healthcare organizations.”