Abstract: Disclosed herein is a computer implemented method and system for improving the quality of health care in a health plan. The members of the health plan eligible for undergoing predetermined measures of health care are identified. The primary care physicians (PCPs) for the identified members are notified to ensure implementation of the predetermined measures. The health plan staff is notified to ensure coordination between the identified members and PCPs. The status of the identified members is updated based on the implemented predetermined measures. Quality indexes for the PCPs are calculated for the implemented predetermined measures. A performance score of the health plan is calculated to indicate the quality of health care. Identifying and notifying the members, the PCPs and the health plan staff reduces the level of clinical chart review by the health plan staff and improves the quality of health care in a health plan.

Abstract: Disclosed herein is a computer implemented method and system for rewarding health care providers using an integrated medical management system. A web application analyzes performance of the health care providers. The web application acquires information from integrated medical management system. The acquired information includes information of health care quality improvement analysis, disease and case based management, utilization analytics, physician profiling, authorizations management, lab and imaging information, and health risk assessment information. The web application determines performance indices for the health care providers based on the acquired information. The performance indices include a quality index, an economic index, and a relative value unit index of the health care providers. The web application analyzes the performance of the health care providers based on the performance indices. The analysis includes identifying health care providers eligible for a reward.

Abstract: Disclosed herein is a computer implemented method and system that addresses the need for an online disease based and case based management of medical care. An online disease and case management system is provided. The information of the patients is retrieved from multiple information sources. The patient information is used to identify one of a disease condition in a patient population and a patient with a disease condition. Further, the patients are enrolled. The enrolled patients are educated about the disease condition for self monitoring of the disease condition. The status of the self monitored disease condition is recorded in a disease log. Visits to a provider are scheduled for medical treatment of the enrolled patients. The enrolled patients are monitored for medical progress based on the medical treatment provided. Further, the disease and case management of medical care are evaluated and reported based on clinical and financial outcomes.

Abstract: Disclosed herein is a computer implemented method and system for rewarding health care providers using an integrated medical management system. A web application analyzes performance of the health care providers. The web application acquires information from integrated medical management system. The acquired information includes information of health care quality improvement analysis, disease and case based management, utilization analytics, physician profiling, authorizations management, lab and imaging information, and health risk assessment information. The web application determines performance indices for the health care providers based on the acquired information. The performance indices include a quality index, an economic index, and a relative value unit index of the health care providers. The web application analyzes the performance of the health care providers based on the performance indices. The analysis includes identifying health care providers eligible for a reward.

Abstract: Disclosed herein is a computer implemented method and system that addresses the need for an online disease based and case based management of medical care. An online disease and case management system is provided. The information of the patients is retrieved from multiple information sources. The patient information is used to identify one of a disease condition in a patient population and a patient with a disease condition. Further, the patients are enrolled. The enrolled patients are educated about the disease condition for self monitoring of the disease condition. The status of the self monitored disease condition is recorded in a disease log. Visits to a provider are scheduled for medical treatment of the enrolled patients. The enrolled patients are monitored for medical progress based on the medical treatment provided. Further, the disease and case management of medical care are evaluated and reported based on clinical and financial outcomes.

Abstract: Disclosed herein is a computer implemented method and system for improving the quality of health care in a health plan. The members of the health plan eligible for undergoing predetermined measures of health care are identified. The primary care physicians (PCPs) for the identified members are notified to ensure implementation of the predetermined measures. The health plan staff is notified to ensure coordination between the identified members and PCPs. The status of the identified members is updated based on the implemented predetermined measures. Quality indexes for the PCPs are calculated for the implemented predetermined measures. A performance score of the health plan is calculated to indicate the quality of health care. Identifying and notifying the members, the PCPs and the health plan staff reduces the level of clinical chart review by the health plan staff and improves the quality of health care in a health plan.