Improvement Opportunities Identified
Care Events Analyzed
Improvement Opportunties
Forecasted Savings
Why
Performance improvement and value-based care
The journey towards value-based care and contracting is often challenging, but there are specific actions that healthcare organizations can take to set the stage for their financial and operational success. Performance focus areas typically include reducing process variation, improving patient experience, and improving outcomes that are direct contributors to both claims cost and provider operational expense.
What makes performance improvement daunting is that financial and administrative teams often face several levels of uncertainty: Which process-level improvement opportunities should be focused on? How much performance improvement is realistic in a given period? What evidence is needed to convince clinicians to change behavior? What process-level improvements are necessary to achieve the desired outcome? What’s the expected ROI?
We designed our predictive analytics solution to answer these questions, and to bring financial confidence to health systems and their partner health plans.
Our Predictive Analytics Solution
Discovers actionable insights by applying machine learning to claims, clinical, operational and patient-reported data
Opportunity Forecaster
- Identifies the highest-impact predictors/drivers of each case-type specific outcome
- Quantifies avoidable cost (claims & provider ops) based on a risk-adjusted performance benchmarking
- Forecasts performance based on realistic process improvement goals
Performance Tracker
- Estimates episode cost for in-flight cases, using model predictions
- Estimates population cost for each contract performance period
- Tracks predictor-level progress towards the organization’s goals
Patient Profiler
- Identifies and ranks patients according to their actual outcomes and their variance-to-predicted
- Generates sortable lists, including favorable and unfavorable outliers
- Drills down into key care steps for each patient
Areas of Performance Improvement
Examples of how clients have leveraged our solution to improve performance and lay the foundation for value-based care
Provider Expense
- Identified sub-optimized direct variable cost drivers
- Quantified net savings for improved staffing and sourcing of surgical implants
Length of Stay
- Identified sub-optimized processes prior to and during hospital stay
- Quantified net savings for improving several care steps including pre-surgical assessment, pain management, ambulation and discharge process
Readmissions
- Identified sub-optimized processes and care-team actions prior to, during and after hospital stay
- Quantified net savings for improving several care steps including patient education, post-acute care setting, transportation, post discharge medication, and follow up visitation
Discover Actionable Insights
See a demo of our solution and also learn about our unique Opportunity Analysis report