|
|
 |
 |
Clinical Best Practice Program
Our Clinical Best Practice Program uses sophisticated analytical and clinical modeling techniques to identify patient safety issues and flag healthcare services that are duplicative or outside evidenced-based practice guidelines. Using this data, we then engage and collaborate with providers to:
-
Increase the use of best-practice procedures that improve health outcomes (e.g., dilated eye exams for diabetic patients),
-
Reduce and eliminate the use or overuse of services that do not improve health outcomes
-
Ensure appropriate coordination and integration of care for patients who receive services from multiple practitioners
-
Provide information and education about current best practices and evidence-based medicine
By transforming healthcare data into relevant feedback, APS gives practitioners prioritized, actionable information they can use to improve health outcomes for their patients.
APS to Manage New York State’s Medicaid Utilization Review Program
|
|
Retrospective review of fee-for-service Medicaid claims for physical and behavioral health
services and pharmaceuticals to identify: patient safety issues, duplicative services, and those
outside of evidence-based guidelines
Provide prioritized, actionable information for providers to use to improve health outcomes for
Medicaid members
"This initiative will advance New York’s efforts to ensure that medically necessary services
are delivered to New York’s Medicaid patients, effectively and efficiently."
— Richard F. Daines, M.D.
NY State Health Commissioner
|
|
