Provider HIE Network

Sure Path Network empowers healthcare providers with robust analytics and near real-time data, giving them immediate insights into their patients' statuses and outcomes. Through timely reports and the Sure Path Provider Portal, providers gain access to crucial information:

• Patient care plans and authorizations: Stay informed about treatment protocols and manage administrative tasks efficiently.

• Medical and pharmacy claims data: Analyze utilization patterns and make informed decisions about resource allocation.

• Lab test results: Monitor patients' health parameters closely and proactively address any concerns.

This access to actionable data and self-service capabilities, including secure messaging, eligibility inquiries, and authorization submissions, supports evidence-based medicine and streamlines administrative tasks, allowing providers to focus on what matters most - patient care.

Informatics, Data Aggregation & Analytics

Sure Path leverages a powerful infrastructure and advanced analytics tools to measure the effectiveness of interventions and drive performance improvement. We utilize diverse healthcare data sources to:

• Identify potential issues: Proactively detect areas requiring attention within your patient population.

• Analyze root causes: Get to the bottom of problems impacting your patients' health and well-being.

• Target specific populations: Tailor interventions to maximize their impact on those who need it most.

• Test and evaluate interventions: Refine your approach based on data-driven insights and continuous improvement.

• Measure overall project effectiveness: Ensure your initiatives are delivering the desired outcomes.

The Sure Path Network, helps identify and prevent avoidable admissions, readmissions, and complications.

Risk Stratification & Cost Management

Our predictive modeling functionality accurately places individuals into risk categories based on demographics, diagnoses, and pharmacy data. This risk score methodology considers individual risk factors for various diagnoses and assigns patients to low-risk, moderate-risk, or high-risk intervention categories.

This targeted approach allows for efficient care allocation and cost management. Our proprietary reporting tools provide comprehensive insights into provider practice patterns, clinical quality, and cost metrics, including HEDIS measures, care gaps, and at-risk individuals.

Predictive Healthcare Analytics & Gap Identification

Sure Path incorporates cutting-edge predictive analytics to inform individual risk identification and outreach efforts. Our care teams utilize comprehensive data sets, including enrollment data, claims, lab results, and social determinants of health, to predict individual health risks and identify the need for specific healthcare services.

By employing predictive analytics early on, we can potentially reduce future utilization rates, healthcare costs, and improve overall health outcomes. Our platform features built-in "alerts" triggered by evidence-based care gap and health risk indicators, prompting care managers, providers, and our care management system to take appropriate action.

Seamless System Integrations

Our service seamlessly integrates with various data sources and systems, including:

• Demographics and health risk assessments

• Biometric screening data

• Care gaps and service authorization data

• Benefit information and event notifications

• Medical/pharmacy claims data

• Person-centered care plans

• Prior authorizations and pre-certifications

• Discharge information and transitional service reviews

This comprehensive integration ensures streamlined information flow and efficient care coordination, ultimately benefiting both healthcare providers and their patients.