Medicaid Disproportionate Share Hospital (DSH)
emPower Suite: Targeted and Powerful Functionality for Program Integrity and Managed Care
emPower: Where Skill and Experience meet Technology and Innovation
Myers and Stauffer, in collaboration with HealthTech Solutions, is excited to offer clients our emPower Suite – a fully configurable software solution comprising a broad suite of tools used for case tracking, analytics, and fraud, waste, and abuse detection/prevention. Although initially designed to support Benefit/Program Integrity (BPI) clients, it also has broad application for managed care clients, making it easier for state managed care program personnel to monitor health plan contract compliance and analyze health outcomes.
emPower is a suite of tools that provides actionable, accurate, and evidence-based analysis and reporting through: emPower Analytics, an Amazon Web Services-based enterprise data warehouse (EDW) module with managed care tracking and analyses subsystems; emPower Integrity, a fraud and abuse detection analytics module; and emPower Tracker, a robust, Salesforce-based, configurable case-tracking system. Industry-leading software platforms and industry-standard security protocols provide support for the entire suite.
A key differentiator of the emPower suite, particularly the emPower Analytics module, is its ability to enhance managed care program oversight. In addition, emPower provides clients dynamic features to support Medicaid programs by putting utilization and clinical data in a usable format at their fingertips.
Our emPower Integrity module not only helps clients identify outlier cases for post-payment review, but it can also be integrated in pre-payment integrity processes to identify potentially problematic providers or billing situations prior to payment. This integration with a state’s claims payment system allows the state to identify scenarios or claims for which the payment should be suspended prior to adjudication. The module also enables the use of information from other data sources that can be critical to enhancing program integrity efforts.
Through intuitive workflow and role-based configurations, emPower Tracker can lead a case through all levels of approvals and red flags, including case reassignments, clinical guidelines compliance, and case resolution.
Proven Track Record
So far, we have won contracts to implement a portion of the emPower suite in the following states:
- Alaska. As a subcontractor to HealthTech Solutions, we implemented emPower Tracker July 2, 2021, for the Medicaid Program Integrity team. We continue to add various case types to the system, in collaboration with the State Program Integrity team.
- Tennessee. As the prime contractor with HealthTech Solutions as our partner, we are implementing emPower Tracker for our first Estate Recovery contract. This system goes live February 1, 2022.
- West Virginia. As the prime contractor with HealthTech Solutions as our partner, we will be implementing the emPower Analytics managed care component for our new managed care contract that begins in 2022.
We continue to seek new ways to support our clients, and we proactively demonstrate these technology solutions to clients and potential clients as opportunities arise.
Mike Johnson, CPA, CFE
Ryan Farrell, CFE