Healthcare payers and providers across the country find themselves in an uncertain time and are wondering about the future of healthcare. While time will tell what specific changes are coming, the reality is that organizations need to find ways to do more with less federal funding in order to achieve the Triple AIM goals – better health, better care, and lower costs. The answer is whole-person care coordination.

Whole-person care coordination treats the full scope of patient needs jointly, whether those needs are medical, behavioral, or socioeconomic. As medical, behavioral health, and community-based providers work together, they are able to see the whole spectrum of patient needs and address multiple conditions simultaneously. This is especially important for super-utilizers who could benefit from coordinated care with guidance, education, and early interventions. The result is improved patient wellbeing and reduced costs for providers as they are able to avoid costly, more intensive care settings such as emergency or institutional care. An integrated care coordination platform is the key to making this happen.

Eccovia Solutions provides unique and proven solutions that help organizations with various structures and care models (states, counties, ACOs, and other human service organizations) to bridge the gap between primary care and community service with a whole-person care tracking, monitoring, and reporting system. Our specialized and flexible ClientTrack Care Coordination platform enables providers to collaborate across multiple agencies and provides the data visualization to measure and report outcomes and meet complex regulatory requirements.

 

Who We Serve

Medicaid Care Coordination

Now is an exciting time for Medicaid technology. State Medicaid programs have long pursued greater coordination and integration of care in order to improve care outcomes, improve the quality of care, and reduce overall costs. In the last few years states have begun developing new delivery system strategies to improve care coordination and integration among traditional and community-based Medicaid providers. In addition, The Centers for Medicare and Medicaid Services is encouraging the adoption of modular, reusable software solutions in order to accomplish this.

Housing First/Housing for Health

Housing First and Housing for Health initiatives seek to place individuals and families in supportive housing as a means to an end. By solving housing issues first, individuals are in a better position to address medical health, substance abuse, behavioral health, employment, and a host of other life issues. Housing for Health programs combine housing assistance, case management, and healthcare treatment to achieve better results at reduced cost.

HMIS

Communities across the country seek to prevent homelessness and find lasting solutions for improving the overall wellbeing and stability for individuals and families experiencing homelessness. This can be a daunting task due to the complex health and social needs of each individual. In addition, the Department of Housing and Urban Development (HUD) requires each Continuum of Care (CoC) to comply with their standards for data collection, management, and reporting. In order to succeed, CoCs need an integrated and flexible Homeless Management Information System (HMIS) to easily coordinate services, track an individual’s progress, and demonstrate effectiveness to HUD.

Behavioral Health

Behavioral health providers must consider the full spectrum of their patients’ condition, including crucial aspects of physical health, mental health, substance abuse issues, chronic conditions, and the social determinants of health that impact patient outcomes. ClientTrack Case Management for Behavioral Health helps providers manage multiple complex aspects of the patient condition to deliver better care.

Long-Term Services and Supports

Managed Long Term Services and Supports (LTSS) requires patient-centric care management. As long-term care patients transition between levels of care and locations of care, it is imperative that vital information travel with them, such as their medical health record, their treatment plan, and their case notes.

Chronic Disease Management

Organizations that serve clients with HIV/AIDS, Alzheimer’s, or other chronic diseases have unique case management needs. Clients need long-term healthcare case management but may also have a complex variety of other needs such as education and counseling, mental health issues, substance abuse, housing needs, employment, or legal concerns. A case management system must be flexible enough to adapt to multiple program demands and assist caseworkers in delivering the best care possible.

Intellectual and Developmental Disabilities

Assisting clients who have intellectual or developmental disabilities presents some of the most challenging case management situations. Caregivers must ensure appropriate care is provided around the clock, day in and day out to patients who may be unable to assist with their own care plan. And not only must the care be provided but it must be accurately recorded and documented for billing purposes.

Case Management for Prisoner Reentry

Prisoner reentry programs are critical in helping released inmates obtain the base of support needed to productively integrate back into society.

Youth and Family Services

ClientTrack is the case management platform of choice for more than 1,200 government and private agencies. With its native cloud architecture, open API, and flexible database platform, ClientTrack is the embodiment of the next-generation system design envisioned for modern CCWIS systems.

Workforce Services

Workforce Services plays an important role in addressing the social determinants of health. Obtaining and maintaining employment provides an important foundation for improving health outcomes for vulnerable populations, (i.e. individuals experiencing homelessness and the intellectually and developmentally disabled). Workforce services agencies often must manage complex sets of information as they collaborate with employers, schools, and community health providers.

Products

The ClientTrack platform is natively designed for today’s collaborative model of care. While many electronic health systems narrowly focus on one aspect of care, ClientTrack incorporates an advanced case management system, flexible database, engagement portal, and reporting and analytics. Information across the full spectrum of the social determinants of health is collected and tracked, leading to better-informed care decisions. Providers no longer have a limited view into their client’s condition. Information collected from any point of care is available to all authorized users.

ClientTrack is ideal for cross-discipline programs, such as housing for health and whole-person care programs that combine aspects of housing, primary medical care, behavioral health, and case management. ClientTrack enables users to create their own unique forms, workflows, and data collection requirements. This allows administrators to tailor the software to fit the specific needs of innovative programs that include information intake on housing, employment, education, medical health, behavioral health, family needs, and a variety of other assessment areas.

In order to incorporate the social determinants of health into healthcare decisions, the information must be readily available. ClientTrack places critical information in the hands of all care providers through a shared platform that combines elements of case management and healthcare delivery. The ClientTrack Online Portal enables clients to report progress updates through the portal with providers and care coordinators who are reviewing the updates and collaborating on next steps.

Case Management Suite

ClientTrack Case Management provides the tools required to manage patient care with multiple agencies across the care continuum. It’s easy workflow and customizable tools simplify tasks and enable case workers and care coordinators identify clients in need of care, assess their needs, develop a customized care plan, and monitor results and outcomes.

ClientTrack Toolset

While ClientTrack solutions include a rich feature-set already designed for most health and human service organizations, in order for organizations to maximize success, it is critical to take into account the unique operation, funding sources, program logic models, and reporting needs of each organization. The ClientTrack Data Management Tools enable organizations with trained technical users to modify the application interface to meet their specific needs, including creating/managing data collection forms, data elements, data structures, business rules, and workflows.

Product Architecture

The technological infrastructure that underpins ClientTrack is as impressive as the software itself. We’ve worked hard to create a technology platform that meets the toughest requirements of today’s high-demand workplaces. Though often operating behind the scenes, these key technologies are vital to delivering the ClientTrack experience

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