Overview

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NextGen Healthcare provides ambulatory EHR and practice management solutions serving over 155,000 providers across primary care, specialty practices, and federally qualified health centers. Known for its specialty-specific templates, robust reporting capabilities, and population health tools, NextGen supports practices navigating the transition from volume-based to value-based care. Stream Health's NextGen integration delivers comprehensive patient record consolidation and gap-in-care analysis that enhances NextGen's native population health capabilities.

With NextGen's focus on specialty practices and integrated behavioral health, Stream Health provides tailored clinical intelligence that addresses specialty-specific quality measures and revenue opportunities often missed by generic population health tools.

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Key features:

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• NextGen Enterprise API Integration: Comprehensive connectivity to NextGen's clinical, financial, and population health systems. Stream Health retrieves patient data across all NextGen modules including EPM (practice management), EHR, patient portal, and population health analytics.

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• Specialty Practice Intelligence: Tailored gap-in-care analysis for specialty practices including: cardiology quality measures and secondary prevention protocols, endocrinology diabetes management and thyroid monitoring, gastroenterology colorectal cancer screening and IBD management, pulmonology asthma control and COPD monitoring, and rheumatology disease-modifying therapy adherence.

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• Integrated Behavioral Health: Support for NextGen's behavioral health documentation with mental health quality measures, substance use disorder treatment protocols, depression screening and follow-up, and behavioral health integration billing codes (99484, 99492-99494).

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• Population Health Enhancement: Stream Health augments NextGen's population health platform by: consolidating external patient data NextGen can't access, validating registry data with NP clinical review, identifying care gaps across fragmented patient records, and providing specialty-specific population health stratification.

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How it works

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Stream Health connects to NextGen Healthcare via their Enterprise APIs and Mirth Connect interface engine, retrieving patient demographics, clinical encounters, problem lists, medications, lab results, immunizations, and specialty-specific clinical data. Our platform consolidates NextGen data with external patient records from hospitals, specialists, imaging centers, labs, and health information exchanges.

The consolidated patient data undergoes AI-powered analysis combined with licensed Nurse Practitioner review, identifying care gaps specific to each practice's specialty mix and patient population. For multi-specialty groups using NextGen, Stream Health provides specialty-specific gap-in-care analysis across all specialties in a unified platform.

Care gap findings and consolidated patient summaries are delivered back to NextGen via bidirectional API integration, appearing in: NextGen's EHR chart and health maintenance module, population health management dashboards and registries, provider workflow queues and clinical inbox, and practice management reports for revenue cycle teams. For practices using NextGen's value-based care contracts feature, Stream Health provides quality measure tracking and predicted performance.

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Benefits of integrating NextGen with Stream Health

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• Enhanced Population Health: NextGen users already invested in population health gain significantly enhanced capabilities through Stream Health's external record consolidation and NP clinical validation. This transforms NextGen's registries from EHR-data-only to comprehensive longitudinal patient records spanning all care settings.

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• Specialty Revenue Optimization: Specialty practices using NextGen gain access to specialty-specific gap-in-care intelligence and billing optimization previously unavailable. For example, cardiology practices identify patients overdue for stress testing, echocardiograms, or lipid panels—each representing significant reimbursement opportunities.

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• MIPS & MACRA Success: NextGen practices participating in MIPS improve quality measure performance by 35-50 points through systematic care gap closure. Stream Health provides specialty-specific MIPS measures, predicts year-end performance with monthly forecasting, identifies highest-impact quality improvement opportunities, and tracks performance against national benchmarks.

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• Value-Based Contract Performance: For practices in ACO, Medicare Advantage, or commercial value-based contracts, Stream Health ensures quality measure compliance and shared savings achievement. Our platform identifies underperforming quality measures by payer, provides patient-specific recommendations with clinical evidence, tracks closure rates in real-time, and calculates estimated value-based care bonus payments.

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• Behavioral Health Integration: Practices using NextGen for integrated behavioral health gain enhanced capabilities including depression screening compliance tracking, behavioral health care gap identification, collaborative care billing optimization (CoCM codes 99492-99494), and psychiatric medication monitoring protocols.

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• FQHC Optimization: Federally qualified health centers using NextGen benefit from Stream Health's UDS (Uniform Data System) reporting support, sliding fee scale considerations, enabling services tracking, and grant program quality measure optimization—helping FQHCs maximize federal funding and meet HRSA requirements.