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How does KEPRO measure performance and what reporting will I receive?

With escalating healthcare costs, the demand for improved clinical outcomes and better value are greater than ever. KEPRO’s fully-owned and data integrated clinical management technology platform allows for real-time healthcare intelligence for monitoring, managing, and improving outcomes. We can tailor our system to meet each client’s requirements and provide feature-rich reporting that support current and long-term needs necessary to improve patient-level outcomes and client ROI. KEPRO’s reporting technology applies evidence-based guidelines aimed at reducing unnecessary utilization and improving health outcomes, quality of life, and savings.

KEPRO has made significant investments in advanced Health Intelligence capabilities. We’ve been warehousing healthcare data, mining it to identify at-risk and high-risk patient populations, and providing meaningful information leading to actionable insights for more than 20 years. KEPRO’s analytic team has expertise in biostatistics, epidemiology, data programming, analyses, and clinical-based research. Our advanced analytic approach and medical management predictive models uncover drivers of high-cost, underlying (or latent) trends, and opportunities to improve inefficiencies and suboptimal clinical outcomes. Important health care questions addressed in our predictive modeling include:

  • Which conditions are most prevalent?
  • Which conditions drive high utilization expenditures?
  • What are acuity-level patient profiles?
  • How does risk differ among patients?
  • How does risk differ among service settings?
  • Which patients are amenable to interventions?
  • Which providers are most efficient?
  • Which disease management programs are needed?
  • What is the projected ROI for case managed patients?

KEPRO’s integrated clinical management platform facilitates reporting and decision-making using a comprehensive view of enrollment, benefits, medical and pharmacy utilization, case management and wellness activities. KEPRO has an outstanding record of producing quality, timely, insightful, accurate, and concise comprehensive reports, in a reader-friendly format.  Graphics provide information at a glance, while in-depth summaries interpret analytics. Reports are divided into three categories:  

  • Client deliverables provide measurements for program activity, customer satisfaction, savings, and helps our clients’ senior management track progress and steer their organizations to success.
  • Data mining reports support quality assurance and help identify areas in need of improvement, shape policies, and generate added services.
  • Operational reports help guide our project teams and allow us to compare ourselves with similar organizations across the nation.

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Please describe KEPRO data security that ensures member information is protected.

As an organization that is charged with storing and transferring Protected Health Information (PHI), KEPRO is bound by HIPAA regulations, and is accustomed to managing the security and privacy of PHI. KEPRO currently exchanges data successfully and confidentially via secure encrypted means in support of all of our federal, state, and local government programs, and with commercial clients.

KEPRO has been implementing and supporting systems that require medical record, data security, and transmission for more than a quarter of a century, and has always placed primary importance on using systems that allow for fast and efficient connectivity, while still providing the highest level of data and system security. Our proven internal and external policies and protocols ensure compliance with state and federal laws and regulations, as well as any additional security measures you may require.

We have a stringent KEPRO Comprehensive Confidentiality Plan that governs our processes. KEPRO’s Privacy Officer, Security Officer, and the Compliance Officer have ultimate responsibility for oversight of the processes and procedures contained in the KEPRO Comprehensive Confidentiality Plan.

KEPRO's system is secure. Our information systems are secured by an in-depth strategy that utilizes multiple layers of operational, management, and technical controls to protect KEPRO assets. We also employ software programs designed to prevent unauthorized use by staff or outside entities.

All KEPRO information systems employ common security controls such as Firewalls, Anti-virus, Role Based Access, FIPS 140-2 Encryption for mobile devices, and the requirement of strong passwords. Information system users are assigned a security role based upon access requirements relevant to their positions and information/program privileges.

The HIPAA Security Rule requires entities to implement information systems that control access to healthcare and related systems. KEPRO adopts a subset of NIST 800-53 Rev 3 Security controls to maintain compliance with HIPAA. Based on these security standards, KEPRO mitigates risk to its Information system by focusing on such controls as:

  • Log-In Security. HIPAA security requires the use of secure User IDs and the use of passwords. KEPRO requires multiple account authentication processes within its information systems to verify the identities of our end-users. KEPRO's policy requires strong passwords that are changed frequently.
  • Access Control. HIPAA requires one of the following: Context Based Access, Role Based Access, or User Based Access. User Based Access is part of the Log-In Security component. KEPRO's Role Based Access gives individual users access relevant to their function in the organization.
  • Audit Trail. HIPAA requires the use of an audit trail to identify who accesses PHI. KEPRO systems track those who change the patient record, the date and time the record was modified, and the specific information changed. The system includes a read only audit trail that captures each time a system user views a case.
  • Session Time-out. KEPRO information systems account for session inactivity by locking screens after 10 minutes of inactivity.
  • KEPRO's physical space is secure. KEPRO’s computer, telephone, and hardware systems are located in climate controlled rooms with fire-suppression and electronic locking system. We allow only authorized access to the room.
  • KEPRO focuses training on confidentiality and security issues. All KEPRO employees undergo rigorous training on security and confidentiality of PHI. We have successfully provided this training to all staff regardless of their respective roles/duties.

KEPRO Headquarters

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777 East Park Drive, Harrisburg, PA 17111
Toll-free: 800.222.0771
Phone: 717.564.8288
Fax: 717.564.3862