What Does Capstone Do? Kim Browning TRHC Executive Vice President

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Presentation transcript:

What Does Capstone Do? Kim Browning TRHC Executive Vice President Mercy Life of AL What Does Capstone Do? Kim Browning TRHC Executive Vice President Richard O. Schamp, MD Chief executive officer George w. brett md chief medical officer David a. wilner MD senior medical consultant Indira kanouka md medical consultant Principles & Practice of Utilization Management -- Richard Schamp, MD

Capstone Performance Systems Leaders and staff at Capstone have >300 client-years of experience in guiding dozens of PACE programs through the complex maze of risk adjustment Thirteen years of risk adjustment consulting experience Purchased April 2014 by Tabula Rasa Healthcare

Locations of Our Valued Clients

Why Capstone? PACE Programs are devoted to providing multidisciplinary care to the frail elderly. However, they must also function as a health plan. Though they insure only a few hundred, the process and procedures required are no different than that for a major health plan insuring thousands of lives Capstone exists to assist PACE in health plan management from proper documentation & coding, to RAPS submission and ultimately to timely payment

Who Are We? Richard Schamp MD: Founder and CEO Kim Browning BS/BA, CHC,PMP : Executive Vice-President, TRHC John Stolze BS: Senior Vice-President George “Mike” Brett MD: Senior VP Consulting, CMO Andrew Schamp BA, BS, MS: Principle Software Architect Indira Kanouka, MD: Medical Consultant David Wilner MD: Senior Medical Consultant Matt Zimmerman BA: Director Client Success Angie Hlad BSN CRN-C: Director Coding/Auditing Services

1/17/2019 Data Collection Data Submission Data Analysis

Capstone Services…Historically Situation Assessments Provider Trainings Monthly Auditing Ouarterly Analytics Front-end coding Retrospective Review Prospective Review Internal Validation Audit Custom Audits Gap Analysis Mock Audit Education & Consulting

Health Plan Management Operational Consultation Retrospective Reviews “Core Services” Risk Adjustment Consulting, Analytics, Auditing Health Plan Management (Former Peak PACE Solutions) Operational Consultation U.M./Q.M. Marketing & Enrollment Consultation Capstone Expands Concurrent Coding “GuardDx” Medical Director & New Provider Training U.M./Q.M. Retrospective Reviews “SucceeDx” Pharmacy: Medication Risk Mitigation Prospective Reviews “ProDx” Medicare Part D Consultation Gap Analysis Prep for 1/3 Financial Audit

Capstone Desires To Invest In Relationships

gbrett@cpstn.com Mercy Life of AL Principles & Practice of Utilization Management -- Richard Schamp, MD