Insights, Analytics, Clinical Outcomes,
Novillus Solution Suite
Care Gap Management
The Novillus Care Gap Management Application (CGMA) offers our clients a comprehensive integrated solution to drive the provider engagement activities essential to achieving performance goals. The CGMA enables bi-lateral clinical data exchange, year-round data capture and care gap closure, ongoing provider coding and documentation education, and provider performance optimization across Medicare Advantage, Medicaid, CHIP, ACA and commercial lines of business.
Through our engagement expertise, industry experience, and intuitive technology, payer and provider partners drive improved HEDIS®, Medicare Star Ratings, and risk adjustment program outcomes.
The Novillus care gap management solution puts actionable, real-time power into the hands of providers. Unleashing these provider actions creates opportunities for faster analysis of emerging trends that directly impact your performance goals.
Insights is the Novillus analytics power tool that compliments the care gap management solution to harness provider actions into clearly understandable visualizations. Armed with decision support information powered by Insights, you’ll be able to take decisive actions to reach or exceed your performance goals.
The Novillus Clean solution provides health plan partners with a continuous audit of provider directory data to ensure 100% accuracy of the provider directory data they publish. The solution is flexible to meet directory validation needs, including which providers are accepting new patients, hours of operation, languages, provider locations, areas of specialty, and much more.
and Support Services
In addition to our innovative technology solutions, Novillus offers client partners strategic support to help them achieve their program and performance goals. Our team of experts come from various health plans across the country with the knowledge and tactical experience to improve performance for HEDIS®, Medicare Star Ratings, Risk Adjustment / Hierarchical Condition Category (HCC) capture, product design, and data quality and architecture. Our team is available to serve on a project basis or as interim full-time support.
Novillus is equipped with a team of certified risk adjustment and HEDIS quality coders to augment health plan resources. Additionally, Novillus has enabled a complete CRM solution with outbound/inbound capabilities to support health plan campaigns and initiatives.
Calculus is a powerful tool for modeling and managing provider performance in Medicare Advantage, Medicaid, CHIP, ACA and value-based contracting programs. Calculus can calculate provider performance and incentives on a daily basis over a range of different reward programs. Model-building tools help you create and try out “what if” provider incentive reward packages and generate financial forecasts; using Calculus trend analysis you can then tie the actual results back to the forecasts. Calculus makes it easy to manage provider incentive payments via 835 EFT on whatever schedule you choose – annual, quarterly or monthly.
Novillus offers clients a state-of-the-art backend system to enhance the accuracy, timeliness and completeness of the data being sourced to support HEDIS®, Medicare Star Ratings, Pharmacy, risk adjustment, and population health programs. Working side-by-side with health plan source data, neXus deploys its proprietary algorithms with a daily refresh to identify care gaps, HCC opportunities, and medication adherence risks to enable providers to have complete, accurate, current clinical, performance, and financial data to drive improved member outcomes.
Novillus was founded on the belief that it should be easier for health plans to collaborate with both their partner provider groups and associated members to provide the data critical to driving improved outcomes and optimal health plan program performance. Centered at the intersection of healthcare and technology, Novillus solves complex health plan data interoperability challenges with digital solutions and engagement expertise.