Value-Based Contracting

With years of actuarial experience and access to comparative industry data, Health Care Analytics designs and implements innovative risk sharing models. Our use of advanced “What-If” scenario modeling makes it easier to determine the most cost-effective contracts. Maximize value with our contract monitoring and settlement solutions.

Risk Score Management

Rapid identification of cost increases in medical services is critical to cost management. Health Care Analytics uses advanced drill down analytic techniques for PMPM trending via multiple variable analysis including major service category, CPT code, ICD-9 code, DRG, benefit, and line of business.

We'll discover medical management opportunities by analyzing practice patterns in relation to hospital bed days, office visits, referral practices, and specialty care procedures resulting in the identification of unnecessary care as well as under-utilization.

Medical Cost & Utilization Analysis

Rapid identification of cost increases in medical services is critical to cost management. Health Care Analytics uses advanced drill down analytic techniques for PMPM trending via multiple variable analysis including major service category, CPT code, ICD-9 code, DRG, benefit, and line of business.

We'll discover medical management opportunities by analyzing practice patterns in relation to hospital bed days, office visits, referral practices, and specialty care procedures resulting in the identification of unnecessary care as well as under-utilization.

Quality of Care Measurement

Health Care Analytics designs tools to measure medical outcomes in order to improve membership health status, attract and retain members or patients, maximize revenue and satisfy state & federal regulatory demands:

  • HEDIS
  • Meanigful Use
  • STARS
  • P4P (Pay for Performance)

Provider Performance

Health Care Analytics designs and produces provider feedback mechanisms such as risk adjusted web-based provider performance measurement reports, support for P4P programs, and customized practice pattern analysis.

Network Profiler

Profile your orgamization's provider network.

Next Steps...

Contact us to learn more about how Health Care Analytics can help you increase quality, control costs and maximize revenue.