Product Overview of Change Healthcare
Change Healthcare is a leading healthcare technology company that provides a comprehensive suite of solutions designed to enhance the efficiency, quality, and cost-effectiveness of healthcare systems. Here’s an overview of what the product does and its key features and functionality.
What Change Healthcare Does
Change Healthcare offers a broad portfolio of solutions that cater to the needs of payers, providers, and patients. The company focuses on value-based healthcare systems, providing tools and services that help customers obtain actionable insights, exchange mission-critical information, control costs, optimize revenue opportunities, and effectively navigate the shift to value-based care.
Key Categories of Solutions
Change Healthcare’s offerings are divided into three main categories:
Network Solutions
Change Healthcare’s Intelligent Healthcare Network is one of the largest healthcare financial and administrative networks in the United States. This network connects approximately 800,000 physicians, 117,000 dentists, 60,000 pharmacies, 5,500 hospitals, nearly 400 vendors, and 600 laboratories, as well as nearly all government and commercial payers. This extensive network processes over 12 billion healthcare-related transactions annually, covering over $2 trillion in claims and touching one in five U.S. patient records.
Software and Data Analytics
The company’s software and analytics platform provides tools for financial performance, clinical decision support, value-based payment models, clinical workflow optimization, and enhanced patient engagement. Key features include payment accuracy solutions for major payers, value-based payment solutions for top Medicare Advantage and managed Medicaid plans, and evidence-based clinical content for hospitals and facilities. The platform also offers radiology and cardiology imaging solutions globally.
Technology-Enabled Services
Change Healthcare provides technology-enabled services that include financial and administrative management, value-based care, communication and payment solutions, pharmacy benefits administration, and healthcare consulting. These services help customers streamline operations, optimize clinical and financial performance, and focus on patient care. The inclusion of AI tools for analytics and operational efficiency is central to these offerings.
Key Features and Functionality
- Revenue Cycle Management: Streamlines financial processes, including claims management and payment accuracy, to optimize revenue opportunities.
- Claims Management: Enables electronic claims submission, tracking, and management to reduce administrative burdens.
- Patient Access: Facilitates patient engagement and access to personal health information, improving patient care and satisfaction.
- Clinical Decision Support: Integrates evidence-based clinical criteria into clinicians’ workflows to support informed patient care decisions.
- Data and Analytics: Provides advanced data analytics to help customers make data-driven decisions, optimize clinical and financial performance, and navigate value-based care models.
- Interoperability: Ensures seamless data exchange across different healthcare systems, enhancing the overall efficiency of healthcare operations.
- Artificial Intelligence (AI): Leverages AI to improve operational efficiency, enhance patient engagement, and support clinical decision-making.
- Cloud Solutions: Utilizes cloud platforms, such as Amazon Web Services, to enhance performance, security, and scalability of healthcare services.
- Payment Solutions: Simplifies financial interactions among care providers, payers, and consumers, ensuring quicker, more accurate, and reliable payments.
- Pharmacy Network Solutions: Manages pharmacy benefits administration and related services, particularly for state Medicaid agencies.
- Consulting Services: Offers healthcare consulting to help customers optimize their operations and navigate the complexities of the healthcare system.
Additional Capabilities
- Optum Pay Integration: Through its partnership with Optum Financial, Change Healthcare offers solutions like Optum Pay, which provides loans based on historical cash flow to help manage financial disruptions.
- Workflow Automation: Automates various workflows to reduce manual errors and increase operational efficiency.
Change Healthcare’s comprehensive suite of solutions is designed to make healthcare simpler, more efficient, and more effective, ultimately inspiring a better healthcare system through improved patient care, choice, and outcomes.