Innovista serves as the bridge between physician practices, patients, and payers—helping to streamline systems and processes so that everyone achieves not only successful outcomes but high satisfaction in a risk-based arrangement.
Why Partner with Innovista?
As today’s environment shifts toward value-based care, practices need an experienced partner to help them navigate the journey to better population health management. Partnering with Innovista can help by:
- Providing detailed, customized coaching on quality improvement, care gap closure, and how to achieve better patient engagement
- Supporting physician quality reporting and interpretation of results
- Measuring outcomes for value-based payments
- Navigating reporting programs for compliance with Centers for Medicare & Medicaid Services (CMS)
- Analyzing data for quality workflows and revenue improvement
How Innovista Serves Physicians
We help physicians and accountable care organizations (ACOs) achieve success through different strategies.
- Savings: Generating savings by reducing costs while maintaining high-quality care
- Coaching: Leveraging data to reduce unnecessary care, close care gaps, and streamline practice workflow
- Patient outreach: Connecting with patients to close care gaps, manage utilization of services, and improve quality of care
- Data collection and analysis: Using payer and practice data and market trends to pinpoint cost-saving and quality-improvement opportunities
- Risk contracts with payers: Negotiating risk contracts on behalf of physicians
- Physician recruitment and network development: Identifying provider partners who can grow and enhance physician networks
Physician Success in 3 Keys Areas Leads to VBC Success
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Ability to grow consistently
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Ability to reduce total cost of care
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Ability to deliver strong operational performance
What Physicians Are Saying About Innovista
Dr. Alvaro Peña
Medical Director,
Oak West Primary Physicians Association
Dr. Jim Walton
President & CEO,
Genesis Physicians Group
Dr. Luis Benavides, MD
President
Seven Flags ACO
How Innovista Serves Payers
We work directly with payers to manage provider contracts and ensure care is aligned to cost. Our services provide predictable margins and cost-effective care for members.
We facilitate success between payers and providers through:
Reduced administrative burden on physicians and office staff
Physician recruitment and network development to grow networks
Analytics-driven insights to risk-stratify populations and support data-driven care management
Quality improvement for better patient outcomes
Data platforms to collect, analyze, and structure data
Integrated clinical care models for seamless transitions of care, which reduces unnecessary and excess medical costs
Provider engagement and management to enable them with the right capital/capabilities to navigate the transition into risk models
Physician & Payer Needs in a VBC Platform
Value-Based Care Platform
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Provider Engagement & Management
Reduced Administrative Burden
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Integrated Clinical Care Model
Physician Network Development
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Data Platform
Analytics-Driven Insights
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Quality Improvement
How Innovista Serves Patients
In value-based care, patients have an ecosystem of services at their disposal, aimed at reducing unnecessary expenditures and addressing underlying factors like social determinants of health (SDOH) that affect healthcare decisions and utilization. We support patients with:
Outreach efforts through community health workers to connect patients with health and social resources, and care managers to facilitate post-discharge care, referrals, assessments, disease-specific education, and more
Closing care gaps by expanding care through annual wellness visit and preventive screening scheduling and compliance
Partnerships with organizations to meet the various needs of patients outside the physician’s office
Comprehensive care management including transitional care and follow-up, disease management, and behavioral case management
Partners
Clinical partnerships are essential to the success of ACOs, helping to reduce emergency department utilization and medical loss ratio, increase quality gap closure and patient/physician satisfaction, and lessen the burden of PCPs. We partner with a number of organizations to fulfill various needs across the spectrum of healthcare.
Behavioral health resources for patients in the comfort of their own home.
Enables patients, case managers, and community health workers to find free or reduced-cost community-based programs to address SDOH.
Enables communication and continually ensures the medical necessity for home health.
Allows patients to express their wishes to family and physicians so that care is for quality of life, not quantity.
Enables communication between in-patient facilities and case managers when a patient discharges to reduce readmission.
Allows for the bypass of the 6-month waiting list so that five meals a week can be delivered to homes.
Allows PCP to see results regardless of who ordered them, increasing gap closure and utilization of in-network facilities, and reducing duplication of labs.
Enables PCP and case manager to follow a patient’s health without them needing to leave their home, thus increasing real-time management of chronic disease and reducing emergency department visits.
Allows the bypass of the traditional 3-day acute stay prior to admitting to SNF; helps case managers ensure patients meet medical necessity for SNF.
Offers PCPs a diabetic eye camera in their practice without purchasing one to perform retinal eye screening in practice, with real-time results.
Provides mobile urgent care that comes to a patient’s home 365 days a year when a PCP is unavailable, reducing emergency department visits.
Success Stories & Testimonials
Tupelolife and Preferred Primary Care were able to treat a patient who needed immediate care to avoid an ED visit and potential hospitalization. The patient was referred to Tupelolife’s Remote Patient Monitoring program for blood pressure control. His initial blood pressure was 212/113 and escalated to 230/123 within a couple hours. Innovista’s RN spoke to the patient’s daughter to assess medication compliance and symptoms related to a hypertensive crisis, but the patient was asymptomatic. The RN called the PCP’s office, who requested the patient come in immediately. Tupelolife’s RN called the daughter, who expedited transportation to the PCP’s office, where catapress was administered and the patient’s blood pressure lowered to 152/78 within a couple hours. His blood pressure is continuing to improve with close monitoring by his doctor.
Innovista community health worker outreach helped reduce one patient’s out-of-pocket costs and time spent in the hospital. In 2021, this patient visited the emergency department 69 times, totaling $34,305. The community health worker worked to mitigate the social determinants of health that were at play and directed her to alternatives for her non-emergent care needs. In 2022, her ED visits plummeted to two unavoidable emergency care encounters totaling $711.
Working with Innovista’s community health worker team, the daughter of a Medicaid member reached out to share progress on her father and appreciation for the assistance they provided: “Thanks for everything. You’re truly a blessing. I know it’s not over. It’s been a long journey but I’m starting to see the change. I am not who I was yesterday, tomorrow I will not be who I am today.”