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Wednesday, February 21, 2024

MedCloud Depot: A One Stop Shop for Value-Based Care Data

“How come we’ve never heard of you?” This is a question that Angel Sanabria, CEO of MedCloud Depot, gets a lot. It’s usually a question followed by something like, “We never knew that these solutions existed out there in an automated fashion.” Both of these statements are testaments to the impact MedCloud Depot is already making in the healthcare technology space as well as the impact the company wants to have further. With so many healthcare companies and practitioner offices looking to transition their businesses to a fully capable automated and ease-of-use system, it’s no wonder that MedCloud Depot is tapping into the complex challenges that the healthcare industry faces today. MedCloud Depot, by becoming one of the leaders in value-based care technology solutions, harnesses the power of combined data to create an overall record of patient health information, financial reporting, management, and referrals/claims, as well as population health, including risk adjustment, prescription drug recommendations, and testing requirements and scheduling. All of this and more is included in Syncrasy, MedCloud Depot’s all-in-one, cloud-based solution. Within the platform, physicians are given full insight into their patient data, processes, and management that will further help improve quality outcomes and maximize reimbursements and organizational revenue. “We are not just analytics; we are value-based care solutions for an entire practice. Whatever you can possibly think or dream of when it comes to healthcare data, we have it, and we even give customers the opportunity to act through it, all within Syncrasy itself,” Sanabria explains. 

What this means is that MedCloud Depot is the only company of its kind in the country that normalizes data across multiple healthcare organizations, enabling true apples-to-apples comparisons.  “One of the greatest challenges in the healthcare industry is that each organization has its own unique system for the processing of their data. This results in many different methodologies and formats for how data is produced in and around the country. MedCloud Depot takes a unique approach to how it handles this data. We normalize and standardize it to CMS standards which allows for the data to be housed in one global source. This results in faster, more efficient processing of the data as well as bringing some of the older systems into the 21st century,” Sanabria explains further. 

Healthcare systems and organizations have had to pivot in recent years due to the transition from a fee-for-service model of healthcare, which is what the US was built around traditionally, and the value-based care model which is now the standard. “Throughout the years, I’ve seen the transition from the fee-for-service world into the value-based care payment methodology. In the early 90s, right when I started, the fee-for-service world was very simple. Whenever you see your physician, your physician sends out a bill and he gets paid for that particular service. Period,” Sanabria explains. “The government realized that our country has been all about volume. Physicians were pushing the patients out as quickly as possible to get paid more,” says Sanabria. Transitioning to the value-based care model meant that physicians were required to report the conditions of patients so that the right funding could be allocated for said patient, all so that better care would be provided. This type of complex reporting and risk assessment has become paramount to physicians and healthcare clinics in receiving adequate funding so they can provide the best care possible to their individual patients. 

This is where MedCloud Depot comes in. Because of the varied and complex information surrounding each individual patient, physicians and healthcare clinics are required to keep a large store of data on individual patients, including things like the number of hospital visits, the tests they’re due to receive, what kind of medication they’re on, any chronic conditions they have, and so much more. Sanabria explains how healthcare providers are now required to close gaps that are almost impossible to keep track of. He explains using this example: “The government mandated the use of performance measures to gauge healthcare quality and said, ‘Well, hold on, we’re going to close gaps.’ What does that mean? From now on, for example, women that are over the age of 60 should have a mammogram done once a year because there’s a high population of women that get breast cancer. So now they’re giving you an additional payment [as a physician]. Whenever you perform certain exams that need to be addressed, you receive the funding. Close the gaps. So the government has been changing from volume to quality of care.” Distilled down to this core, this is what value-based care means. Funding is allocated based on the type of care needed and provided to individual patients. It’s not about volume anymore. This change means that physicians and healthcare clinics need a platform that will help them organize all these data points and make the information fluid, accessible, and actionable. “If you have a system alerting you constantly and closing these gaps with the patients, that’s tremendous. Without a platform like Syncrasy, you cannot successfully run value-based care in our country,” Sanabria says.

As Sanabria explains the technology, he pulls up a comprehensive look of the platform online, introducing a value-based care system toolkit that users plugged into Syncrasy have access to. Included in the toolkit are “modules” which are categorized and then, when clicked on, open to an even greater set of data points that correspond to the module name. For example, patient membership is one such module which, when opened, lists new member information and current member information. “Anything you can possibly think of in terms of membership is in this module. Who are the members assigned to you, and what are you getting paid for them? A capitation.  A certain amount every single month. That’s important.” There’s also an ‘Expenses’ module. “If these patients or these members here get sick, those expenses are deducted from you. So the insurance company also has to share the expenses. They look at things like, ‘How much am I spending in hospital? How much am I spending on a particular drug? How many patients are prescribed this drug?’ Physicians need to make claims based on these medical expenses. These get reported. For example, here I am receiving every bill for my patients. If my patient Smith goes to the hospital and the hospital charges a dollar, then that month the insurance company deducts the dollar from my funding and the medical claim will appear in Syncrasy,” Sanabria says, also emphasizing how important it is to have access to expense and claims information when healthcare clinics need to report this, especially to insurance companies. 

Other modules include things like ‘Funding’ that gives an overview of how much you’re receiving as a physician or healthcare clinician for every patient. If Smith has more health complications, you may receive more funding to be allocated to Smith’s individual needs. Risk scores, also listed in the module, give a sense of how much funding each patient should need given their health status. There’s a module that lists hospital visits made by certain patients. Another module includes ‘Pharmacy’ and ‘Drugs’ that list which drugs are being prescribed to patients and any additional rebates that the physician encounters. Questions that physicians may have that require answers include things like, “How much am I spending in pharmacy? How much am I spending in this particular drug and who is prescribing it?” Sanabria explains. This module also contains symptom information listed by the drug company so that physicians are aware when prescribing. “Take Eliquis for example. [When I click on the drug], I get a picture of the drug, I get the route, the NDC number, the legal status, I get equivalent drugs that could be prescribed and that cost less,” Sanabria explains. It’s an entire drug database that users also receive. 

There are hierarchical condition categories that physicians have insight to when using Syncrasy, including adverse conditions some patients may have that require certain testing to be administered and cost summaries associated. Quality assurance is another module that gives physicians a glimpse of their entire patient network. Other modules provide insight into factors like security, lab results, referrals, claims submissions, insurance providers (of patients too), reporting guidelines, policies (including clinical notes from other healthcare providers), other clinical records, patient history, medical loss ratios, patient eligibility, and even things like customer relations management which acts as an engagement mechanism to oversee the obtainment of new patients. Alongside engagement and enrollment is also a retention module that aims at retaining patients, including by facilitating outreach operations to understand why patients left so that a clinic can make the necessary changes to their office conditions or processes. A rewards module seeks to retain clients too, operating on a points-based system that corresponds with necessary patient visits and testing.

MedCloud Depot is a “one stop shop” for healthcare providers, providing all information necessary for their value-based care operations. The platform is automated, easy to use, interactive, and integrated into the larger healthcare systems that operate in the United States, meaning that all data points that a patient is associated with are convened into one, integrated space: Syncrasy.

Many healthcare systems that providers have are broken systems that don’t integrate all components fully. Most systems also do not provide patient portals versus MedCloud Depot’s Syncrasy gives patients the ability to see their own health data through a phone app. And  MedCloud Depot is always innovating using the latest technologies. An example of the company’s innovations hinges on something that Sanabria himself created where reporting could be combined in a way that made the process easier for physicians. “If I asked you [as a physician] how much did you spend in all your insurance companies together, you’d have to run every single report separately and then manually, and then come up with the math and sum it up. In our system, I was able, with my experience doing this for 29 years, to map and standardize every single file from every insurance company in the country to a standard so that when you run a report once, when you go to filter, you can filter or combine a la carte all the insurance companies you want and those that you don’t want. So now you get all your results combined across every insurance company even though their systems are completely different and do not talk to each other. What we’ve given the providers is unheard of in the country,” Sanabria explains. This line of thinking also speaks to the fact that, at the moment, most of the exchange of health information does not happen in real-time. MedCloud Depot is looking to fix this by connecting the dots between all organizations and storing it within their comprehensive and holistic platform.

More than anything, with MedCloud Depot, it’s about recognizing each and every individual patient as possessing unique needs and allocating care based on those needs. It’s also about educating patients further on their own health by providing access to their health data and keeping them up to date on their check-ups, tests, and medication needs. Sanabria is overseeing the development of new add-ons and systems that will further help healthcare providers produce the best value-based care results with innovations continually evolving such as building out a CCM (chronic case management) module, a comprehensive electronic health record module, and even a module that indicates the transportation method used by some elderly patients who can receive insurance to cover their travel expenses. With the system continually being built, the level of integration that MedCloud Depot adopts is what puts them on top as the leading provider of value-based care solutions. 

MedCloud Depot also practices what they preach. As an organization spearheaded by Sanabria, the vision for MedCloud Depot started with people: how can patient life be improved to the utmost degree? Because Sanabria spent his early career within healthcare itself, he leads with expertise and know-how. But this level of care extends to MedCloud Depot’s own employees. “Look, I’m the owner of the company and [hard times] happen to me too when I’m having issues at home, right? So I am human, just like them. So I understand that it’s important that their personal life is also aligned for them to be able to come to work happy,” Sanabria explains. This workplace culture dedicated to employee health and care aligns to the company’s overall mission of helping clinics and physicians provide the best care possible to individuals, ensuring that nobody gets left behind.

 

MedCloud Depot
M

Angel Sanabria, CEO

www.medclouddepot.com

“If you have a system alerting you constantly and closing these gaps with the patients, that's tremendous. Without a platform like Syncrasy, you cannot successfully run value-based care in our country”

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