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2023 Year in Review: Progress, Preparation and Priorities for the Year Ahead

Jeff-Brandes-CircleBy: Jeff Brandes, President & CEO

As 2023 has come to a close, I wanted to take a moment to reflect on the past year.  With the chaos of the “pandemic years” behind us, I feel like I can finally dive in and talk about the fantastic year we had at Azara, all of the cities and states our staff visited and the variety of achievements by our customers, team and company.  However, I again want to acknowledge that COVID-19 and its aftermath have made a long-term impact on our world and that of our clients and their patients. In particular, we have witnessed a herculean effort by our provider clients to help make up for lost time and deferred care, including the thousands of annual checkups, immunizations and disease screenings that have been missed since 2020.  These are fundamental things that keep individuals healthy; identifying and treating conditions and disease early and assuring patients are given every opportunity to adjust their course to minimize long-term, permanent damage and complications. 

We also know that there are still many folks out there struggling with their mental health, having difficulty making ends meet and keeping their families healthy.  We see what you, those on the front lines, face each day and applaud your hard work, selfless sacrifice, and the downright resilience you have shown to assure your patients, many of whom have no other options for healthcare, continued to be well cared for under these most difficult of circumstances.

2023 was not without its unique challenges and unexpected ups and downs here at Azara, but all in all a year we are pleased with.  Q1 was highlighted by three major milestones; 1) Azara being honored as Best in KLAS Population Health Management Solution for 2023 2) the launch of Azara Cost & Utilization, our cost analysis tool for our provider and network clients operating in full risk value-based care contracts and 3) the wind down of the legacy SPH Ignite Product. 

Spring was filled with excitement as our team planned and prepared to host 400+ clients and partners, in-person, for the 7th Annual Azara User Conference.  What an event it was, our largest user conference ever, which included three days jam packed with presentations where many of our clients and partners highlighted how they are using Azara products, and the information they provide, to improve the health and lives of their patients on a daily basis.  I think everyone walked away feeling energized and loaded up with great new ideas to put into practice. 

Fall brought the clearest signal yet that the pandemic has ended, as the in-person events of conference season overtook the schedules of all of our client facing staff and a few of those brave enough to volunteer to jump into the fray to help out.  It was refreshing as I traveled to San Diego for the NACHC Community Health Institute (CHI) and reconnected with so many clients, partners and friends.  As we tied up the year, collectively, Azara staff attended 32 conferences in 30 states between September and November. 

As our teams traversed the country, we consistently observed a set themes, concerns and initiatives across the varied clients, geographies, and domains that we touched: 1) An awareness and focus on health equity, 2) Movement toward more value-based care, 3) Staffing shortages and 4) Desire for more collaboration between Primary Care and Behavioral Health.  I am happy to report Azara has products, services and innovation initiatives to help our clients in each of these areas and we will continue to listen to your needs, ideas and desires so that we can be there to assist you for many years to come.

Being a perpetual optimist, I can only reflect and hope that 2023’s positive progress will prepare us all for the great things that lie ahead for 2024 and the opportunities and challenges that await us.

2023 Highlights

Best in KLAS

In early February, we were notified that Azara was named the 2023 Best in KLAS Software and Services ReportTM vendor for Population Health Management, with high scores across all six customer experience pillars.  A Best in KLAS award signifies to the healthcare industry the commitment and partnership that top vendors should provide.  For me, the award is directly representative of our team’s hard work and dedication to the success of our clients; and while holding the top spot is certainly an honor, I am more excited to see Azara’s consistently high scores over the past four years, as KLAS scores are based solely on customer interviews and feedback related to their experience and service received.

Annual User Conference

In May, nearly 500 Azara users and staff from across the nation joined us in Boston, in person, at our 7th Annual User Conference. It was refreshing and invigorating to see and interact with so many old friends while also making a number of new acquaintances.  I marveled at the energy and excitement that our clients and partners brought as they each extended and enhanced their own personal DRVS support networks.  Our team and our clients once again did a great job lining up excellent content and fostering high quality networking opportunities.  The agenda was packed full, and we were fortunate to have a large number of outstanding guest and customer presenters, highlighted by an excellent Keynote presentation from Dr. Sandro Galea, Dean and Robert A. Knox Professor at Boston University School of Public Health, who spoke about using data to create health and narrow health gaps and disparities.  He made an excellent analogy on addressing social drivers of health, comparing the healthcare system to a soccer team – an excellent goalie and an excellent provider will help win games and save lives respectively, but the majority of the game and majority of people’s lives should be played up field, scoring goals and promoting health.

Another recurring topic at the User Conference was value-based care and the different avenues practices can take to achieve success in risk-based contracts.  Across multiple sessions, attendees and presenters had the opportunity to explore strategies on how to impact costs, quality and access to care using the tools within Azara DRVS.  The Journey to Value-Based Care session also emphasized the importance of enabling services such as care management and care coordination in helping patients achieve optimal outcomes and propel success in these value-based care models.  While VBC mastery may at times seem like a distant and unattainable goal, my experience during our user conference and in speaking with clients and partners across the country this year, tells me while there may be much work ahead, Azara users are making steady forward progress toward the goal line.

I continue to be overwhelmed and humbled by the enthusiasm, passion and dedication of our customers and that could not have been more evident during these three days.  Our 2024 agenda is coming together as I write this and I hope you will join us April 30-May 2 back in Boston.  Registration will open in early February and more information can be found here.  

Company Milestones

In June, Azara once again received certification from the National Committee for Quality Assurance (NCQA) for HEDIS® Measure Year (MY) 2023 Health Plan and Allowable Adjustments Measures. Together with the newly certified HEDIS measures, Azara maintains one of the industry’s largest active measure libraries with over 800 discrete quality measures, spanning dozens of practice specialties and programs. 

In September, we announced our partnership with the Kentucky Primary Care Association (KPCA) and their Kentucky Primary Care Clinically Integrated Network (KPC CIN) with Azara DRVS serving as the backbone of their analytics infrastructure, integrating clinical and claims data and positioning their network to succeed in value-based care.  I am excited to report that in a very short time they already have a number of their member practices up and running and a plan to bring the remainder live at a steady pace throughout early 2024.  The addition of KPCA brings the number of multi-practice networks that have selected or are using Azara DRVS to 38. 

In October, Azara received its 3rd HITRUST “interim” compliance certificate, as this program is on a two-year cycle for full audits, with partial “interim” audits done in the alternating years.  HITRUST Certified verifies that Azara has set up and maintains the Common Security Framework (CSF), which combines nationally and internationally accepted standards including ISO, NIST, PCI and HIPAA to ensure a comprehensive set of baseline security controls.  While this continues to be a critical milestone for us, the responsible stewardship of your patient data is of utmost importance and we will continue to invest in the people, processes, technology and programs necessary to keep your data safe.  

In November, we completed our 3rd Certification (2nd Re-Certification) in the NCQA’s Data Aggregator Validation program—an exhaustive review of the process, systems and data standards as well as the Output Data Integrity standards which Azara follows to provide clinical data to payers for use as standard supplemental data for HEDIS®.  We also decided to expand the scope of our ONC-Health IT Certifications to include more measures and successfully completed Drummond Group’s ONC-ACB 2015 Edition Cures Certification for Azara DRVS.  As the month concluded, Azara was recognized as a winner of the prestigious Gold dotcom Award for Outstanding Website design with our partner Stirling Brandworks.

As we kick off the new year, I can see that through mid-December nearly 4.2 million DRVS reports have been run in 2023 by close to 24,000 unique users.  In December 2023, there were 11,000 active DRVS users, over one thousand more than last December.  Looking inward, our team is now more than 160 professionals spread across 19 states.

Product Offerings

Like other years, we went into 2023 with a roadmap and plan containing a large list of enhancements and new functionality that we hoped to deliver.  

In February, after almost of year of development and testing, we rolled out Azara Costs & Utilization (ACU), our cost analytics tool designed to meet the needs of clients in value-based contracts with full or significant risk.  This product is now deployed across a number of clients and has been met with great enthusiasm.

As the winter turned into spring, our Product and Engineering teams delivered a big push of new features and functionality ahead of our User Conference.  This included having the UDS 2023 Measures deployed in April, again earlier than any previous year. 

With the announcement in February of the end of the COVID-19 Public Health Emergency, we recognized the need for our clients to have a means to oversee and assist their patients with the Medicaid re-determination process and quickly moved to add additional capabilities to DRVS, Azara Care Connect and Azara Patient Outreach to support these efforts, many of which will continue into 2024.  So much for a well thought out 12-month, product development roadmap. 😉

Spring brought some long-awaited technical detail from HRSA on UDS+ and the determination that the 2023 submission would be voluntary.  With the specifications now available, our development team dove in quickly and we were proud to have been one of the first entities to test part of the submission infrastructure at the HL7 Connect-a-thon in March.  In the fall, Azara became the first vendor to pass synthetic testing and at this point, we are one of three HIT vendors to submit and pass testing with UDS+ data.  As we head into January, Azara has the necessary functionality within DRVS to allow our clients to take part in the HRSA UDS+ 2023 optional submission process and our team is prepared to assist those who choose to participate.

While the users of Azara DRVS regularly see the efforts of our teams’ hard work in the form of new features and functionality, I want to highlight some of the unsung infrastructure enhancements that not only improve our ability to deliver high performing software, but also increase the quality of your data.  Throughout 2023, a cross-functional effort, spearheaded by our Data Quality Team, created and began to deploy a machine learning model targeted at better identifying incoming lab data and increasing the throughput on our ability to map unknown/unidentified labs to LOINC codes, a previously manual process, by more than 6X.  To provide some perspective, 55% of the 3 million labs we received in 2023 from client EHR systems did not have an associated LOINC code, so this enhancement has wide ranging impact.  Through this process, we have been able to harness the power of machine learning in a controlled environment for which it is well suited, far away from the use cases that are controversial and need significant oversight.  We see a number of other areas within data quality for us to use this technology and will be expanding the scope of our efforts throughout 2024.

Fall brought our first production deployments of the product integrations with the two leading referral networks of community based services, findhelp and UniteUs.  DRVS and ACC users now have one-click access with single-sign on and data auto-populate to the referral capabilities within these powerful tools.

As fall turned to winter, we completed one of the larger primary care/behavioral health integration projects we undertook in 2023.  Through DRVS, this specific project has enabled five Community Health Centers to share key elements of patient and visit data with five partner Certified Community Behavioral Health Organizations.  While this project is still in the early phases, our experience here and in similar projects is signaling that sharing of the most basic information, such as who are the patients seeking care at both facilities, is extremely valuable in assuring proper and effective treatments for both physical and mental health.  We are already engaged on a number of “like” initiatives for 2024 and I anticipate there will be much more activity in this area.

As the year came to an end, our product development team was in the final stages of completing significant enhancements to Azara Care Connect (ACC), our care coordination and care management application.  The addition of structured care plans and evidence-based care pathways will allow our clients’ care management teams to better track their activities and impact patient health.  We will be rolling out these enhancements with one of our partner networks in early 2024 and hope to begin previewing them to a wider audience by late spring. 

Throughout 2023, Azara continued to invest in product development and meaningfully expand the capabilities of our product suite.  With many of our clients now entering into value-based contracts, data exchange with payers remained a priority as we continued to enhance DRVS’ ability for tracking attribution, improving risk coding, and better reconciliation of care gaps between clinical (EHR) and payer (claims) data and now with ACU, analyzing the costs of services being provided both within and outside of primary care.  It is clear that our clients continue to steadily advance down this path, and we saw a meaningful increase in the number of clients with access to payer data (enrollment, care gaps and claims) from their managed care plans.  We activated multiple relationships with new payers, including a third leading national Medicaid plan, around data exchange and our team is in active conversations with two others with which we expect to establish similar partnerships in early 2024. 

Our team is regularly looking closely at the functionality and tools our clients will require in the months and years ahead and we plan to continue to make significant investments in infrastructure and reporting related to operating within value-based contracts.  We look forward to rolling these out throughout 2024.

Growth

In 2023, Azara continued to increase both its client base and revenue, strengthening our balance sheet and assuring we can continue to invest in ongoing innovations.  Azara now has well over 600 DRVS clients in 42 states, Washington DC and the US Virgin Islands.  We added sixteen new staff members, enhancing our capabilities and capacity in all areas of our business.

We have continued to grow both our clinical transformation team and the client success/account management function as we want to be confident that all our clients are receiving the attention they need to be successful with our products.  As we look ahead to 2024, we will continue to invest in the resources necessary to assure our products meet your needs and our staff has the time to give your projects adequate attention.

Extracurricular

On August 5-6, 2023, eight riders represented Azara Healthcare in the Pan Mass Challenge (PMC) 2023. This year’s Azara team ride featured pleasant riding conditions, overachieved fundraising milestones, and fancy custom Azara team jerseys. The Azara BKRS trained throughout the summer, joining together for rides and even adjusting commutes to bike into the office.  

While each of the team members had their own reasons for riding, they were again all brought together for this event to honor the memory of our dear friend and colleague, Heather Budd, whom we lost to this horrible disease in November of 2021.  Collectively the Azara BKRS, with strong support from the entire staff, were able to raise over $45,000, 100% of which will go directly to cancer research for the Dana Farber Cancer Center and the Jimmy Fund.  The PMC ride is the largest athletic fundraiser in the world, and Azara is honored to be a part of this impressive event.  Thank you to all who supported the team and donated and look for an even bigger Azara BKRS contingent in 2024.

On a different note, this fall, Azara made a commitment to allow each of our staff to have a paid day off for community service.  A number of our team members have already given their time and energy to one of their local organizations and I look forward to describing some of the wonderful ways they have utilized this benefit in next years’ update.  If your organization has a project that could use some helpers, I encourage you to engage your local Azara staff to see if they might want to utilize their day in support of your efforts.

While 2023 was a great year on many fronts, I am even more energized for 2024.  The breadth and depth of opportunities that we plan to address with our clients and partners this year is enormous.  We look forward to helping you solve new problems and introducing innovative solutions and functionality that can assist you in accomplishing your mission.  I expect the journey on the road to value-based care to continue, awareness and focus on health equity and behavioral health integration to increase, and I believe Azara clients are well positioned and have much of the information they need to act and succeed in all of these initiatives. 

The pandemic has brought the issue of availability and access to high-quality data and information in healthcare settings to the forefront and I urge you to look at your data early and often and to find ways to integrate that information into your day-to-day decisions and delivery of care.  A high-performing care team can’t operate to the best of its abilities without useful and accurate data.

Lastly, on behalf of all of us at Azara, I want to thank you, our clients and partners, for your unwavering support.  It is an honor to be able to serve you and your teams as you work tirelessly, in very challenging conditions, to assure that no patient—no matter the circumstances—goes without the healthcare services they need.  Hopefully, Azara’s assistance has in some way aided you in accomplishing your mission and goals this year.

We look forward to joining you on your journey for 2024.  I extend our best wishes for a Happy and Healthy New Year!