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

Quantifiable, Predictive, Actionable: Specialty Health…by Healthmap

Healthmap’s specialty health management programs are designed to meet our clients where they are on the specialty health spectrum, all fully developed, tested and proven in many different healthcare settings:

  • Comprehensive specialty health management services, with flexible risk options, comprised of data and analytics, evidence-based best practice clinical guidelines and automated decision-making tools.
  • Our care navigation and provider account teams collaborate with primary care and specialist practices to deliver and help implement overall population health management and individual patient care plans, including a critical medication management component that identifies and flags medication contraindications and recommends course corrections.
  • Our condition care management specialty health programs focus on progressive disease states, with a particular expertise on Kidney Health Management as the leading fully independent solution in the U.S. Click here for more on the Healthmap Solutions Kidney Health Management.

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.