Tech Firms Can Help Cut Health Costs

Brentwood-based NaviHealth, Nashville-based Medalogix shape up amid health reform

A sharper focus on keeping people out of the hospital or from returning within a month after discharge means business opportunities for Nashville’s health sector and companies with the right technology to aid patients.

Brentwood-based NaviHealth and Nashville-based Medalogix are among companies riding a wave of helping hospitals and other providers take care of patients at the right time with the right care in the right setting.

Business models of both companies involve using analytical tools to help predict the future. Their work is considered important as Medicare plans to change how it pays for care starting this October. It’s moving toward penalizing those hospitals that have higher-than-average rates of patient readmissions.

“Hospitals are beginning to seek out relationships with nursing homes, home health agencies and other post-acute providers that are doing a great job of keeping those patients from coming back to the hospital within that 30-day window,” said Dan Hogan, Medalogix’s CEO.

Medalogix’s analytical tool is used by 14 home health-care agencies, and the company plans to work with nursing homes and then hospital systems.

Its software analyzes patients’ medication records and other clinical information to predict who’s most at risk of being sent to the hospital within 60 days.

Medalogix recently netted $100,000 in financing from angel investors to bolster its operations.


NaviHealth weighs in on quality, costs

NaviHealth works mostly with commercial and private Medicare Advantage health plans. The company helps determine the right setting for patients, the type of care needed, and it manages the transition from acute-care to the patient’s home to prevent unnecessary hospital readmissions.

“For us it’s preventing readmissions, but also as they move through the post-acute phase, driving higher quality at lower costs,” said Clay Richards, NaviHealth’s president.

While most of NaviHealth’s growth is from managed care plans, Richards sees long-term growth opportunities in working with accountable care organizations and hospitals.

The company’s pitch involves taking on some of the post-acute risks as hospitals move more to a value-based model, shouldering responsibilities for cost and quality of care and helping patients as they progress. Its goal is to prevent unnecessary readmissions by using proprietary technology to better understand risk factors and come up with a plan to deal with any physical limitations a patient might have.

Jason Dinger, CEO of MissionPoint Health Partners, sees opportunities for innovative companies. MissionPoint is part of the Saint Thomas Health hospital system with which NaviHealth works. He says the push to contain costs and boost quality is still evolving as federal health reform plays out.

“The wider discussion is what (are) the historical gaps in care in our health system, and how is the post-reform movement filling those gaps,” he said.

Getahn Ward covers the business of health care. Reach him at 615-726-5968 or at [email protected]. Follow him on Twitter @Getahn.