The Healthcare IT industry is under enormous pressure to provide customers and staff optimal service while improving patient care. Consequently, IT has become an integral part of the healthcare landscape and IT Service Management (ITSM) makes it possible to better manage the processes to support such organizations. Blue Eagle offers ITSM with specialized services such as upfront advisory, implementation, optimization, staff augmentation, data analytics, and more to help their clients overcome this ever-increasing pressure.
How a solution provider engages its services, their track record, and the value/return derived by its clients are becoming even more intensely scrutinized. And, there is a shortage of such quality firms with long-standing reputations for delivering highly skilled and experienced resources for specific deliverables. To offer the best services and affect a desired change, it is very important to understand the ‘how’, ‘when’ and ‘why’ of a client’s organization. So, to bridge this gap, Blue Eagle has been offering its unique customized services to its clients. Blue Eagle partners with its clients to provide optimal use of software investments, data analytics of highly digitized and comprehensive information, as well as value-based outcomes for both patient care and reimbursement.
Blue Eagle focuses on ensuring that the quality and value of their deliverables is a match to an individual clients’ needs. The company’s focus on Healthcare IT and Operations needs enables them to focus on critical areas that are too often ignored by solution providers in this market such as Value Base Care, Interoperability, FHIR based software development, and Data Analytics.
As an example, Blue Eagle has long term relationships with two of the largest health benefits companies in the United States. Blue Eagle has been a crucial partner in helping them address sudden and large fluctuations in Membership and/or Enrollment that in turn creates huge Prior Authorization (PA) backlogs. Blue Eagle has developed a service line of highly experienced and immediately available PA Nurses to augment existing UM Departments staff whom can be onboarded and productive in 3-5 days. This unique, “PRN” type model allows Health Plan clients to “flex” the number of PA nurses needed on a weekly/monthly basis which in turn means they are only paying for the resources “when and how” they are needed, by the hours worked and productivity achieved. It’s a very efficient service model for Health Plans, both in terms of cost and productivity.
The turnaround burden related to the amount and complexity of payer pre-certification/clinical review requirements has increased dramatically in recent years. Healthcare providers are under greater pressure to identify innovative ways to meet these demands to ensure safety, better clinical outcomes, compliance, and payment certainty for the services they provide. Blue Eagle’s rare ability to provide a customized blend of resources from its pool of over fifty (50) highly experience Payor Clinical Review nurses translates into its Health Plan clients initially engaging as few as 2-3 nurses or as high as 20 + to perform primarily Utilization Management activities for Inpatient or Outpatient Prior Authorization (PA) Requests. However, in a short amount of time these clients learn that Blue Eagle’s PRN nursing pool is rich with a wide range of state licensures, software systems experience, and quality credentials (i.e. Medical Necessity Clinical Criteria (InterQual), with knowledge of NCQA guidelines), and almost every client takes advantage of using Blue Eagle resources in these areas as well.
Blue Eagle’s innovative approach to assisting Health Plan UM Department with Clinical Review Nurse staffing has proven to be 100% effective in helping its clients save hundreds of thousands of dollars in penalty costs, while also delivering faster and more accurate PA processing and greater overall success rate. One client’s membership increased by 180,000, due to CMS reassignments, which resulted in a substantial spike in Prior Authorizations (PA) for covered benefits and services. Blue Eagle’s unique and proven ability to augment this client’s existing clinical support in weeks was critical in allowing them to meet their contracted Turn-Around-Times (TAT), while eliminating a backlog of 3,500 PA’s; saving approximately $1.8M in adverted damages through dramatically increased productivity and quality. Post their initial engagements, Blue Eagle has re-contracted in four (4) additional agreements to have them provide Clinical Review Nurse staffing for State Medicaid Plan populations for existing new Health Plan clients.
Historically, Blue Eagle generates 70 percent of their revenue from either Health Plan or Provider organizations. While that percentage remains the same overall, over the past three years, BEC is seeing a growing portion of revenue coming from two (2) new niches they have strategically and purposely developed: (1) several big strategic partners and (2) Contract nurses for Prior Authorizations in Health Plans. Blue Eagle’s ‘Low Risk/High Return’ proposition to their clients forms the key factor behind the company’s success. Over 15 years the company has successfully complete 640 engagements. “In the end, our business is predicated on how the “right people” will deliver the “right results”. We have made that our passion and continue to deliver on that promise to our clients”, says Mark Griffin, President of Blue Eagle Consulting.