MDFlow Care Management System
An Innovative and Complete Solution for Your Care Management Programs

MDFlow Care Management System has achieved National Committee for Quality Assurance (NCQA) Pre-validation for Population Health Management (PHM) and Case Management (CM).

As only one of few pre-validated PHM system vendors designated by the NCQA, MDFlow can now help its clients meet NCQA Health Plan Accreditation (HPA), Population Health Program Accreditation (PHP), Case Management Accreditation (CM), and Managed Behavioral Healthcare Organizations Accreditation (MBHO) requirements.

MDFlow Care Management System is member‐centric, integrated, easy-to-use and customizable cloud-based Population Health Managemenrt (PHM) and Case Management (CM) software. The system is developed to help healthcare organizations to implement and manage the case and disease management programs.

MDFlow Care Management System provides the functionalities and integration of information to manage complex healthcare needs. MDFlow Care Management System streamlines and enhances the flow of information throughout the entire case management process, including candidate identification through assessment, stratification, care plan development, documentation, member engagement and care coordination. Our system does not only follows and meets the regulatory requirements and national clinical guidelines, but also provides our clients with the flexibility to customize it to meet their specific business needs and requirements. Our system helps our clients to implement and manage an evidence-based, patient-centered care management strategy. With our sophisticated data analytics, workflow management, care coordination and reporting capabilities, our clients can identify high-impact opportunities and maintain compliance every step of the way.

Our clients include SNP/MA plans with 5-star rating, value-based care provider groups, case management organizations, managed behavioral healthcare organizations and Government agencies


  • Candidate identification and data mining
  • Assessments (Health Risk Assessment, disease specific and other user defined assessments, with acuity stratification)
  • Care coordination and collaboration management (medical, social services, behavioral health and community based resources), including identification and integration of the interdisciplinary care team
  • Evidence-based and individualized care plan (ICP) development with S.M.A.R.T. Goals
  • Identification and integration of the interdisciplinary care team
  • Scheduling and task management
  • Member education and engagement
  • Real-time patient eligibility verifications with most health plans
  • Comprehensive medication management
  • Documentation and correspondence management
  • Post hospital discharge care management to meet transition of care needs
  • Interface with State HIEs, Hospital ADT Feeds and Integration of Direct Messaging and HL7 FHIR
  • User friendly member care profile visualization
  • Compliance tracking and management of Gaps in Care
  • Document scanning and management
  • Data Analytics, Reporting and business intelligence
  • Secured messaging and communications - efax, eMail and SMS (between patients, case managers, PCPs, specialists, family members, caregivers, ...)
  • Integration of lab data, clinical data (EHR systems) and utilization data (claims, pharmacy)
  • Telehealth and Remote Patient Monitoring (RPM)

MDFlow Care Management System is based on Microsoft technology. It provides high availability and scalability. MDFlow Care Management System is delivered as a software-as-a-service (SaaS) model. It enables rapid system deployment and features a tremendous degree of customizability. It makes on-going software maintenance, modifications and enhancements more efficient and cost effective, and it also eases the future implementations of new regulations, requirements and business initiatives.

Our staff will assist you in setting up and configuring the system to best fit your care management needs. MDFlow Care Management System is well-supported by our knowledgeable and friendly support team.

MDFlow Clinical Consulting Services

With our Healthcare Information Technology platform and clinical consulting services, we enable our clients to effectively and efficiently manage their comprehensive health care needs and deliver consistent and result-driven outcomes.

Our clinical consulting team is a group of healthcare professionals with extensive knowledge and qualifications in the managed care field. There are over 70+ years of cumulative experience in the healthcare industry. Our consulting services include:

  • Support health care organizations in the execution and implementation of the MDFlow technology.
  • Provide support throughout the entire implementation process and post-implementation to ensure handoffs are seamless.
  • SNP Model of Care development with review and auditing, chronic disease program design, TOC, palliative and hospice programs, utilization management, and NCQA accreditation assistance.
  • Perform gap analysis and provide recommendations to mitigate any identified gaps as well as design a tailored work plan that includes structure, program descriptions, process, policies, communications, staffing, training, and reporting.
  • Ensure the execution of the work plan, including regulatory and accreditation standards applicable to the organization while focusing on the uniqueness of the organization.
  • Align with the organizations mission, innovation efforts and growth.