GuidingCare is a comprehensive and modular care management platform by HealthEdge, specifically designed for health plans and payer organizations to optimize care coordination, improve health outcomes, and reduce operational inefficiencies. The solution suite includes modules for Care Management, Utilization Management, Appeals & Grievances, Authorization Portal, Business Intelligence, and Population Health Management.
Key Capabilities & Features:
- Advanced Care Coordination: Enables seamless collaboration across multidisciplinary care teams, prioritizing interventions and closing care gaps.
- Automated Care Planning: Leverages patient data and assessments to proactively build and sustain comprehensive, person-centered care plans.
- Utilization Management: Supports the complete authorization lifecycle, integrating with evidence-based clinical guidelines like MCG Cite AutoAuth and InterQual Connect™.
- Population Health Management: Features advanced gaps-in-care analytics to identify and proactively manage high-risk populations, aligning with quality measures like HEDIS and Star ratings.
- Mobile Clinician App: Provides field-based clinicians with an intuitive, secure mobile application (Windows and iOS) offering offline access to member information, assessments, and care plans.
- Interoperability: Built with a Smart on FHIR integration suite to connect the entire vendor ecosystem effortlessly, ensuring real-time data exchange.
GuidingCare is positioned as a mission-critical solution that drives digital transformation for payers, enabling them to streamline workflows, meet regulatory demands, and deliver holistic, whole-person care.