Medical Cost Management
  • Leverages targeting algorithms based on specific disease state
  • Personalized interventions based on patient history
  • Care coordination between Healthmap and practice office
  • Healthmap care navigators managed telephonic encounters
  • Available via omnichannel framework
  • Generation of quality metrics per population
  • NCQA, CMS and Payer-specific measurement stewards
  • Care gaps generated as data that impacts are received
  • Care gaps presented via pre-visit planning paradigm
  • Care gap opportunities aligned with visit schedules
  • Available via omnichannel framework


  • Based on industry standard algorithms (e.g. HCC)
  • Identify opportunities along with optimal coding guidelines
  • Data collection fed to billing resources necessary to avoid timely filing penalties
  • Available via omnichannel framework

The Future of Kidney Health Management from Healthmap

A population health solution … one valued patient at a time

Healthmap is the leading kidney health management program that is fueled by clinical data, proprietary high-powered analytics and care management expertise that identifies patient risk factors before their condition worsens.

The Healthmap Kidney Health Management Solution:


Reduces cost of care by $15 to $20 per member per month (PMPM)

Lowers ER use and unplanned hospital admissions

Increases quality scores for the complex chronic kidney disease (CKD) and end-stage renal disease (ESRD) patient populations

Improves Medicare Risk Adjustment scores

The Healthmap Kidney Health Management clinical team, backed by our Scientific Advisory Board, uses predictive modeling to identify opportunities for impact and develop and deliver a custom care plan for each patient.  The unique and proven Healthmap approach is based on evidence-based best practice clinical guidelines and automated decision-making tools in collaboration with the primary care physician practice. 


Healthmap has a flexible financial model that includes taking financial risk tied to PMPM performance, and the completely scalable kidney health management program fits particularly well into value-based care models. 


Healthmap has answers to critically important questions such as:

  • How do you have clear, quantifiable and actionable visibility into your current CKD/ESRD populations – who they are, kidney disease stage, risk level and cost?
  • Given that early stage CKD is asymptomatic and often goes undetected until later stages, is it possible to identify trends, predict which patients are likely to worsen and intervene to positively influence outcomes?
  • Can you consistently manage this population across every touch point in the CKD/ESRD care continuum and across comorbidities for each individual patient?

Value Based Programs

Applying evidenced based medicine, whether at the point of care for practicing clinicians, or point of approval for managed care organizations, is limited by available data and access to the appropriate evidenced based guidelines and medical policies. Healthmap Solutions gathers data from disparate sources and then feeds that data into its Clinical Decision Support solution which applies the data against a growing library of evidence based medical guidelines and recommendations. Our health coaches reinforce these guidelines through care coordination and interventional support. This level of automated decision making coupled with individual outreach supports a scalable solution that improves the health of the patient, resulting in lower cost of care.

Care Gap Analysis

The marriage of hospital, claims, laboratory, pharmacy, and EHR data creates a longitudinal, 360 degree view of a patient's care gaps and potential health risks. We leverage our Campaign Management Platform to coordinate the multiple quality and cost campaigns an organization will deploy for its population of patients to optimize patient and provider communication efficiency. Healthmap Solutions is a firm believer that identifying and acting on care gaps at point of service, whether acute or chronic, results in improved quality and risk scores.

Clinical and Financial Data Exchange

Healthmap’s data exchange service simplifies what remains a challenge for most organizations. This simple, yet revolutionary approach to data exchange between internal and external applications gives us the edge when it comes to aggregating data from disparate systems. We gather multiple formats of data, pass it through our data mediation layer, normalize the data, and then enrich the data to pass it to you in an easy to consume and actionable format. This allows you to focus on delivering your value proposition, rather than spending time on data gathering exercises.