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Regulatory Mandates

ACA presents opportunities and demands

With the implementation of the Affordable Care Act (ACA), healthcare payers will be accountable for performance reporting across a wide variety of initiatives ranging from HEDIS performance and Medical Loss Ratio (MLR) compliance to patient safety and chronic disease management. It will require a whole new level of collaboration across internal entities and external partners to capture and correctly use the information that is needed for compliance and transparency.

While payers can leverage past investments in data warehousing, reporting and analytics to get started, data collection and integration are still cumbersome and time consuming. No single, accurate source exists for patient, provider and other data that are the basis for mandated reports. To meet the demands and leverage the opportunities of the ACA, payers need to invest in modernizing their information management environments to integrate data from a wide variety of sources and share it across multiple audiences such as patients, providers, health information exchanges, CMS and other regulatory agencies.  The result of this effort will be faster, more accurate reporting and compliance.

Develop the reporting and analytics you need to meet ACA requirements

Ajilitee’s Affordable Care Act Reporting Services are designed to help payers integrate and access the data they need to better serve patients and meet compliance and reporting mandates. We offer a variety of strategy services and workshops to help payers understand what it takes to integrate data across all sources to overcome challenges of ACA reporting mandates.  Ajilitee provides in-depth services that help payers plan, architect, and develop the following Affordable Care Act reporting solutions:

  • Develop an enterprise ACA Compliance and Regulatory Reporting and Analytics Hub leveraging the data warehouse that will focus on providing mandated reporting and analytics
  • Assist with ACA data governance to institute policies for guiding the use of compliance data, establish decision rules, document data definitions and processes, and assign Data Stewards to manage data quality, availability, archive and access control

Get your ACA Reporting solution to market faster with our healthcare-focused accelerators

A collection of business and technology accelerators leverage the experience across our healthcare client network to greatly improve speed to market and reduce overall project risk.

  • Data quality framework: Apply a consistent, objective approach to data quality, using our comprehensive approach, which includes data governance/data stewardship, data integration, master data management, and metadata management.
  • Reference architecture: Our reference architecture gives you a starting point that you can tailor for your data environment and business needs. Our reference architecture promotes speed to market, reusability, consistency, standards, architectural governance, reduced cost of ownership, and a single version of the truth.
  • Data governance framework: Use our framework to help define how your organization will manage the collection, availability, integrity, use, and security of data across entities. Our framework provides you with templates for your mission statement, policy creation, and process flow; defines suggested roles and responsibilities; and outlines workflows, data flows, pain points, and much more.

The value of ACA reporting and compliance

High quality care delivery: Improve patient outcomes, lower cost for effective outcomes, improve patient experience, improve quality of care
Reduce and avoid expenses: Reduce occurrences of adverse events, improve operational efficiencies, focus resources on growing service lines, predict timely interventions, identify problem areas in patient treatment, avoid regulatory noncompliance costs, avoid high cost and low value care management activities, avoid future redundant data and systems
Enhance patient and physician experience: Improve quality reputation and reduce risk of legal actions
Raise barriers for competition: Raise service experience expectations, improve patient and physician loyalty, increase patient service effectiveness
Improve management insights: Improve quality of decision data, improve speed of access to decision

Recognized

Inc 5000 2014 LaunchPoint 100

Inc. magazine has ranked LaunchPoint, parent company of Ajilitee, #100 in its 2014 Inc. 5000 list of fastest-growing privately held companies in the U.S.