Executive Summary

Healthcare providers shouldn’t spend more time on paperwork than on patient care. Payers shouldn’t wait for providers to decide on preventive care delivery planning. But that’s exactly what a global Healthtech company’s customers faced. Their population health management application was outdated, slow, and demanding. Customers were frustrated, and growth was stalling. In just three months, Paltech delivered—an AI-powered, innovative app that automated tasks, streamlined workflows, and transformed operations for both payers and providers. Historical clinical and social determinants of health (SDOH) data were migrated seamlessly, care plans were created in minutes, and revenue models improved. The Healthtech firm didn’t just upgrade software—they unlocked time, efficiency, and long-term growth.

Business Problem

Outdated systems created bottlenecks, frustration, and stalled growth

The client’s population health management app had become a productivity black hole. Nurses spent hours navigating complex workflows instead of caring for patients. Every care plan required excessive data entry, endless clicks, and manual workarounds. Clinics were frustrated, growth slowed, and competitors offering simpler tools gained ground. The administrative burden was draining time, energy, and resources.

For payers, the challenge was even more pronounced. Internal communication across care management, disease management, and utilization management teams relied heavily on emails, leading to fragmented workflows. The complexity and manual nature of these processes resulted in inefficiencies, delays, and increased administrative burden. The stakes were high. If left unresolved, staff burnout and operational inefficiency would hurt care quality and profitability. providers & payers would continue to lose time and revenue. The client needed a better way—fast.

Solution Implemented

AI-driven innovation delivered streamlined, efficient population health management

The goal was clear: build a modern, lightweight application that integrates seamlessly with clinical workflows, cuts admin time, supports better patient care, and reduces the cost of care. Paltech, with its proven healthcare expertise and delivery track record, took on the challenge.

Key Solutions Delivered:

AI-Driven Data Risk profiling

• Embedded AI to automatically stratify risk scores for patients based on historical clinical info and Social Determinants of Health.
• Ensured continuity with existing patient clinical records.
• Impact: Immediate access to risk-stratified patient info for efficient care management

Seamless workflow integration across payer departments

• Integrated the workflows of the care manager, disease manager, and utilization manager to have a 360-degree view of the member risk profile.
• Ensured real-time synchronization with clinical data and SDOH data.
• Impact: Clinics now manage care plans within their existing systems effortlessly.

Increased revenue with a shared risk model of Value-Based payments

• AI-driven feed to help providers act immediately on high-priority cases and increase the quality of care alongside reduced resource utilization
• Compliance with quality of care guidelines as per the VBP contract
• Impact: Attracted more VBP-driven exclusive contractual agreements with payers.

Cloud-Based Microservices Architecture

• Transitioned from a monolithic, on-prem system to a cloud-native infrastructure.
• Improved performance, scalability, and maintenance ease.
• Impact: Faster app performance and simplified IT management.

AI-driven smart reporting

• Built an AI-driven smart dashboard for real-time tracking of patient risk score movement.
• Instead of standalone graphs, a generative AI-driven chatbot gave insights and recommendations on each patient profile
• Impact: Super Users can now make quick effective decisions

Enhanced Security Measures

• Built AI-driven security agents to continuously monitor outliers and alert the security team.
• Adopted best practices to secure sensitive patient PHI information.
• Impact: Data integrity and regulatory compliance ensured.

Application Overhaul & Simplification

• Migrated the decade-old system to a modern, lightweight app.
• Removed unnecessary features to simplify population health planning.
• Impact: Nurses now spend more time with patients and less time with screens.

Automated Documentation & Referrals

•  Automated creation of Medicare-compliant care plans, referrals, and care goals.
• Utilization management documents are automatically pulled from EHRs into the population health system
• Impact: Care plans are generated in minutes, not hours.

Benefits Achieved

Measurable results with faster workflows, happier teams, and better care

The launch delivered substantial, high-impact benefits for the client. The once-complex population health management process became streamlined, intuitive, and significantly faster.

Key Benefits:

● Time Savings: Care plan creation time is reduced from hours to minutes.

● Increased Revenue: Achieved compliance with value-based payment method increased revenue

● Improved Accuracy: Automation minimized manual errors and ensured Medicaid compliance.

● Simplified Onboarding: Easy installation process enabled rapid adoption across clinics.

Nurses and GPs reported greater job satisfaction as they spent less time on paperwork and more time with patients. The AI-powered migration of old care plans ensured no historical data was lost, maintaining care continuity. The support team benefited from a robust admin dashboard, providing real-time insights into clinic performance and simplifying issue resolution.

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