Clinical Decision Support, Healthcare Payment Reform

Gain strategic insights to prepare for payment reform

To deliver the highest level of care while controlling costs, providers must focus on managing clinical, financial, and performance risk factors. Verisk Health supports payment reform efforts with proven, industry leading risk assessment, data aggregation, and quality measurement solutions. Our toolset is fueled by advanced healthcare analytics and provides a clear picture of the cost, utilization, and quality drivers that affect a provider’s performance and financial sustainability.

Accountable care that improves clinical outcomes and optimizes the bottom line

Providers delivering accountable care services must perform many of the same initiatives traditionally implemented by payors, including care management, risk-contract assessment, and performance measurement. Our solutions help to facilitate cost-effective population health management, inform mutually advantageous risk contracts, and maximize revenue from quality-based bonus programs.

Verisk Health supports providers with solutions for:

Proactive Care Management
Stratify and prioritize populations by identifying high risk patients along with their illness burden and gaps in care. Pinpoint those likely to be hospitalized, allocate clinical resources appropriately, and develop proactive strategies for improving quality and reducing costs.
Clinical Decision Support & Risk Assessment
Get a longitudinal view of patient data to support impactful clinical decision making. Our evidence-based medical rules and sophisticated predictive models provide strategic insight into risk before it turns into high costs—giving you time to take action and improve the outcomes of patient engagements.
Financial Risk Assessment
Manage risk contracting initiatives with accurate and detailed population health assessment. Evaluate the fairness of risk-based financing systems by analyzing the costly conditions affecting your patients and predicting future costs and utilization needs.
Variation Measurement
Develop analyses of providers' performance to improve outcomes and create a transparent understanding with payors. Quantify practice and physician variation, benchmark performance, and establish clinical best practices based on cost-effective care delivery.
Practice Management
Analyze financial metrics, utilization trends, and practice leakage to identify areas for improvement and optimize financial and performance results.
Performance-Based Reimbursement
Develop fair and efficient provider reimbursement methods, facilitating transparency and alignment of physician economics with payor payment models.

Products and services we offer providers include:

Sightlines™ Provider Intelligence »

Our data analytics and reporting platform supports proactive clinical outreach, financial risk assessment, and provider performance measurement. The solution pinpoints opportunities for medically sound and financially effective interventions while enabling providers to manage healthcare risk and maximize revenue potential.

Sightlines™ DxCG Risk Solutions »

The industry standard of risk adjustment and prediction engines with our new payment and performance solution module is used to analyze and quantify both financial and clinical risk. Use it as a stand-alone tool or inside our Sightlines Provider Intelligence platform.