Clinical Intelligence Across the Post-Acute Journey

Powered across the journey by Anna® Clinical Intelligence

• 1Acute & Discharge Planning

  Stage 1

  Acute Hospital Discharge

  In the member journey

  A member is approaching discharge from the acute setting, and the appropriate next setting, provider, and post-acute plan need to be determined.

  Health plan need

  Earlier visibility into likely post-acute needs and the appropriate next setting, with relevant clinical and network context.

  Relevant Anna capabilities

  • Post-acute discharge planning
  • Appropriate setting intelligence
  • Earlier visibility into post-acute needs
  • Clinical context
  • Network considerations

  Associated PAA solutions

  • Anna Network OptimizationSNFHome Health
  • Anna Care EnablementCross-Continuum

  Value Enabled

  Earlier visibility, better transitions

  Bring clinical and network intelligence forward so teams can plan appropriate post-acute transitions earlier.

  • Earlier Visibility
  • Appropriate Setting
  • Transition Planning

  Anna supports the discharge-planning workflow with intelligence. It does not replace hospital discharge planners.

• 2Prior Authorization

  Stage 2

  Prior Authorization

  In the member journey

  A request is submitted for post-acute care, and the health plan must determine whether the requested setting and services are clinically appropriate.

  Health plan need

  Consistent, timely, and well-documented medical-necessity review while reducing unnecessary administrative burden.

  Relevant Anna capabilities

  • Clinical context
  • Documentation intelligence
  • Clinical recommendations
  • Prior authorization workflow support
  • Automation
  • Consistent clinical review
  • Medical-necessity decision support

  Associated PAA solution

  • Anna Prior AuthorizationSNFHome Health

  Value Enabled

  Quicker to yes, Greater clinical focus

  Automate 50%+ of appropriate authorization requests to approval, helping members get to "yes" faster while focusing licensed clinicians on ambiguous and clinically complex cases where their expertise matters most.

  • 50%+ Automation
  • Quicker to Yes
  • Clinical Focus

  Anna surfaces clinical context and recommendations while licensed clinical reviewers retain responsibility for coverage determinations.

• 3Post-Acute Placement

  Stage 3

  Post-Acute Placement

  In the member journey

  Once post-acute care is appropriate, the member needs to transition to a provider capable of supporting the episode effectively.

  Health plan need

  Support appropriate provider selection using relevant network intelligence and provider performance information.

  Relevant Anna capabilities

  • Network intelligence
  • Provider performance visibility
  • Post-acute provider selection support
  • Appropriate placement
  • Network optimization

  Associated PAA solution

  • Anna Network OptimizationSNFHome Health

  Value Enabled

  Right provider, right setting

  Bring network and provider-performance intelligence into placement decisions to support more appropriate post-acute transitions.

  • Provider Performance
  • Appropriate Placement
  • Network Optimization
• 4SNF Episode Management

  Stage 4

  SNF Episode Management

  In the member journey

  Once the member enters SNF care, teams need ongoing visibility into the anticipated episode, clinical progress, continued skilled need, emerging risk, and readiness for transition.

  Health plan need

  Proactive visibility across the SNF episode so teams can manage continued stay, identify changes earlier, and begin discharge planning well before the end of the episode.

  Relevant Anna capabilities

  • SNF EMR Integration
  • Clinical Data Ingestion
  • ADT Integration
  • Clinical Intelligence
  • Criteria Review Intelligence
  • Continued Stay Review
  • Skilled Need Visibility
  • Clinical Change Identification
  • Discharge Readiness
  • MD Escalation
  • Clinical Summaries
  • Workflow Automation

  Associated PAA solution

  • Anna Continued StaySNF

  Value Enabled

  70% less manual review. More proactive episode management.

  Integrate clinical documentation and ADT data directly from SNF workflows, reducing administrative burden and giving utilization management teams more timely visibility into the episode. Anna® applies Clinical Intelligence to organize clinical evidence into standardized review workflows, reducing manual criteria review time by up to 70% while surfacing changes in skilled need, clinical status, and discharge readiness for earlier clinical review.

  • Up to 70% Less Review Time
  • EMR + ADT Integration
  • Proactive Clinical Review

  Anna provides Clinical Intelligence and decision support while clinical reviewers retain appropriate decision authority.

• 5Transition Home

  Stage 5

  Transition Home

  In the member journey

  As the member approaches discharge, teams need visibility into transition needs and potential gaps that could affect a safe and timely transition home.

  Health plan need

  Identify transition needs and potential gaps early enough for care teams to coordinate the appropriate next steps.

  Relevant Anna capabilities

  • Discharge intelligence
  • Transition planning
  • Care coordination
  • Identification of potential transition gaps
  • Follow-up opportunities
  • Home health identification where appropriate

  Associated PAA solutions

  • Anna Care EnablementCross-Continuum
  • Anna Home HealthHome Health

  Value Enabled

  Fewer gaps, stronger transitions

  Identify transition needs and potential care gaps earlier so teams can coordinate the right interventions before and after discharge.

  • Care Gap Identification
  • Transition Coordination
  • Timely Intervention
• 6Home & Community

  Stage 6

  Home & Community

  In the member journey

  After leaving facility-based care, the member may transition into home health, community-based care, and ongoing health-plan care-management workflows.

  Health plan need

  Extend visibility beyond the facility episode to support home-based care, follow-up, care-gap identification, quality, and outcomes.

  Relevant Anna capabilities

  • Home Health EMR Integration
  • Clinical Data Ingestion
  • Recertification Intelligence
  • Clinical Summaries
  • Workflow Automation
  • Care Planning Intelligence
  • Transition-of-Care Intelligence
  • Care-Gap Identification
  • Readmission-Risk Insights
  • Follow-Up Opportunities
  • Quality & Outcome Visibility

  Associated PAA solutions

  • Anna Home HealthHome Health
  • Anna Care EnablementCross-Continuum

  Value Enabled

  40%+ recertification automation. Greater clinical focus.

  Connect directly with home health EMRs to bring relevant clinical data into health plan workflows, enabling 40%+ of clinically appropriate recertifications to be automated while focusing licensed clinical expertise on cases requiring additional review. Across the transition home, Anna® also surfaces care gaps, follow-up opportunities, readmission risk, and outcome insights to support more coordinated care beyond the facility.

  • 40%+ Automation
  • Lower Administrative Burden
  • Care Continuity

  Anna automates clinically appropriate recertification workflows and surfaces insights, while licensed clinical reviewers retain responsibility for medical-necessity and coverage determinations.