Case Study: Maui Medical Group streamlines capitation management and reporting with Open Practice

No independent practice can afford to try to operate with the basic practice management and billing capabilities that come with the EHR

Maui Medical Group (MMG), Hawaii's largest multi-specialty medical group, faced a significant challenge when its largest insurance carrier moved to a capitated payment model. This shift created a complex need for a new audit and adjudication process to ensure accurate payments for their 25,000+ attributed members, a task that risked millions in potential errors. Open Practice was enlisted to develop a solution.

Working with MMG, Open Practice developed and implemented new functionality within their OpenPM system to manage monthly data uploads and generate audit reports. This solution automated the reconciliation process, saving an estimated $45,000-$60,000 annually in potential employee costs and safeguarding against significant financial discrepancies. The client reported the new, painless process effectively saves time, prevents headaches, and protects revenue.

Maui Medical Group

Cliff Alakai

Chief Executive Officer