Two Objectives. Both Achieved.
Hear from Derek Marcusky of Elite Healthcare Partners on how ForeSee Medical helped elevate an already high-performing practice—driving shared savings with their largest payer and doubling PCF program revenue. Watch the video below.
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“As soon as we implemented ForeSee, things completely turned around.”
Your Role in the Organization
I’m Derek Marcusky, the Practice Manager at Elite Healthcare Partners. My primary role is overseeing the day-to-day operations of the practice and everything that comes along with that. It’s a lot of oversight and coordination. I also spend a significant amount of time on provider education. We hold monthly provider meetings to keep everyone up to date on new rules, initiatives, and other important changes.
Before ForeSee
Prior to ForeSee, our entire risk adjustment process involved receiving data from the payers and then putting that information directly in front of the providers during patient appointments. We would place the information into the appointment note so the provider knew what needed to be addressed during the visit. That was our workflow before ForeSee.
After ForeSee
After implementing ForeSee, the process became much simpler because instead of manually gathering and organizing all of that payer data ourselves, ForeSee was essentially doing it for us. Any documentation we uploaded into the chart was automatically scanned by ForeSee, and it would provide recommendations based on the information it found.
Anything Surprise You?
“ForeSee helped us more than double program revenue.”
We had two very specific objectives we hoped to accomplish with ForeSee, and I’m happy to say that both goals were achieved. Our first objective was to begin generating shared savings with one of our largest payers, Humana. Prior to ForeSee, we struggled to achieve shared savings with them, but as soon as we implemented the platform, things completely turned around. To this day, we continue to consistently surplus with Humana, which has been a huge success for us.
The second objective involved a CMS program called Primary Care First. Unfortunately, the program has since been discontinued, but at the time it used different risk groups based on the MRA codes of your patient population. The payment differences between those risk groups were substantial. Our goal was to move from Risk Group 2 to Risk Group 3, which would more than double the revenue we received from the program. I’m very happy to say that ForeSee helped us accomplish that goal as well.
How About the Service?
We work closely with Jorge, and he has always been phenomenal. He’s incredibly responsive whenever I reach out to him by email, and he’s consistently been very helpful. Since we first started using ForeSee several years ago, he has always been there to support us, and we really appreciate that level of partnership and service.
See how AI-powered risk adjustment can help your organization improve RAF accuracy, increase shared savings, and streamline chart reviews. Request a demo of ForeSee Medical today and discover what better documentation and smarter workflows can do for your team.
Blog by: The ForeSee Medical Team