Clinical risk management

Clinical risk management in a value-based healthcare environment.

For healthcare organizations making the shift to value-based care, clinical risk management must include a strong focus on the post-acute care process.

Clinical risk management has traditionally been concerned with identifying, containing and managing risks related to patient safety. Under value-based payment models where reimbursement is tied to quality of outcomes rather than quantity of services, clinical risk management and hospital risk management must also consider and mitigate any risks to functional patient outcomes. And nowhere is the risk of less-than-ideal outcomes greater than in the post-acute care journey.

After discharge from an acute setting, coordinating post-acute care becomes quite complex. Getting multiple providers on the same page and ensuring clear and consistent communication with patients, caregivers and families is quite a challenge. And monitoring and tracking recovery progress is much harder after patients leave the four walls of the hospital.

To improve clinical risk management, reduce the risk of readmission and ensure that patients are getting the post-acute care they require, healthcare organizations need powerful solutions and a patient care management system that can streamline tasks and automate processes for post-acute care. That’s where naviHealth can help.

Improve clinical risk management with naviHealth.

naviHealth has been managing post-acute care and care transitions for health plans and health systems for nearly two decades. Providing clinical support services, advisory solutions and data-driven technologies, we enable payers and providers to better navigate care transitions, enhance patient experiences, reduce costs and increase quality across the continuum to improve clinical risk management.

To help healthcare organizations navigate the fundamental shift to value-based care, we offer deep expertise and experience in value-based payment models. Our team includes former staff from the Center for Medicare & Medicaid Innovation (CMMI), as well as national consultants who have designed and implemented value-based programs nationwide. With help from naviHealth, healthcare organizations can improve clinical risk management by more easily maximizing reimbursements and improving patient outcomes throughout the care continuum.

An Experienced Partner

We’ve spent more than 18 years pioneering ways to improve every aspect of care transitions for health plans, providers and patients. From discharge planning efficiencies to managing risk for payors and providers, naviHealth is equipped to provide you with a tailored suite of capabilities.

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naviHealth solutions for clinical risk management.

To simplify clinical risk management, we provide a range of solutions that help to improve patient outcomes while lowering costs and reducing waste.

  • Our scalable technologies help to simplify hospital case management and discharge processes, accurately predicting a patient’s need for post-acute care and creating an individualized patient care plan that ensures the right amount of care in the optimal setting for the most appropriate period of time.
  • Our clinical support services provide access to skilled clinicians who can be embedded at hospitals and in post-acute facilities to help steward patients to the best next level of care.
  • Our advisory solutions provide up-front assessments of workflows, discharge patterns and post-acute networks to help improve efficiencies, enhance network relationships and increase positive patient outcomes.

Learn more about clinical risk management and naviHealth, and about naviHealth hospital management software.


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