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Health Plan

Health Plan

As payer, provider, employer and consumer relationships align with value-based care, we connect key information about your population to help you engage members and promote optimal health.

To help you identify gaps in care and engage members in their health, our big data platform, HealtheIntentSM, aggregates and normalizes data from various sources to create a longitudinal record for each member.

Our solutions and services, powered by our big data platform, provide data-driven insights into key metrics that impact populations across your various health plans.

FAQs

How does Cerner support health plans that offer Medicare Advantage plans?

Our solutions are designed to help health plans understand where members may be experiencing gaps in care, gain a view into the performance of your provider network and recognize areas costing you the most. Our big data platform, HealtheIntent, delivers data insights in near real-time to help you make more-informed decisions. The solutions also help with key revenue opportunities, such as insight into Hierarchical Condition Category (HCC) coding accuracy and the clinical data needed to impact your Medicare Advantage Star Rating.

Cerner uses clinical and financial data aggregated in HealtheIntent, along with health-belief data obtained from our Cerner WellnessSM personal health assessments, to categorize populations into groups. Once a population is segmented, personalized engagement plans can be created to help increase engagement levels. Our strategy includes a health navigator and coach who engage with members based on their beliefs, preferences and behaviors.

Cerner has obtained NCQA certifications in the areas of Wellness and Health Promotion (WHP) and Health Information Products (HIP). The WHP certifications earned are in the areas of Health Appraisal and Self-Management Tools for our Cerner Wellness solution and Health Coaching for our Health Coaching Services.

We serve more than 190 organizations across our employer, government and health plan segments, and our health information technologies (HIT) connect people and systems at more than 25,000 provider facilities worldwide. Health plans also benefit from what we have learned as a self-insured employer managing the health and care of more than 25,000 of our own associates and their families. Serving as a ‘living lab’ for our solutions and services enables us to quickly innovate. We’ve experienced results, such as a minimizing our annual premium increase to 2.8 percent and gaining $17M in productivity savings.

Related Offerings

Analytics

To identify and monitor opportunities for improvement, Cerner offers a comprehensive suite of analytic solutions that enables organizations to make data-driven decisions and perform advanced analysis tailored to their organization-specific needs and goals, leveraging aggregated and normalized data across the community. 

Benefits Administration

If you are a provider-sponsored plan, to help make benefit administration easier for you and provide a seamless experience for your members, we provide claims processing and manage integration with your wellness programs.

Care Management

To compliment your care management strategy, Cerner offers services ranging from advisory, to concierge and health navigation, to a team of dedicated care managers that provide health coaching and care coordination for your members. To achieve optimal quality and costs, Cerner's care management solutions support a person-centric approach of proactive surveillance, coordination and facilitation of health services across the health continuum.

Longitudinal Record

To enable you to make more-informed decisions, Cerner offers a longitudinal record designed to provide an organized, summary view of a member’s health and care story that is comprised of normalized data from disparate systems across the health continuum.

Member Engagement

To aid health plans in empowering members, families and care teams to be active participants, Cerner offers member engagement solutions that enable a member and the rest of their care team to be aligned, informed and educated on an ongoing basis.

Registries and Scorecards

To proactively identify gaps in care, recommend targeted interventions and provider performance, Cerner offers a registries and scorecards solution that enables organizations to identify, attribute, measure and monitor people and providers at an individual or population level.

Health and Wellness

To aid in automating and managing an effective wellness program, Cerner has a web-based wellness solution that promotes members engaging in their health. To support your wellness initiatives, our consultants handle everything from creating a strategic plan, to administration of your program, including communications and access to dietitians and trainers.