The Problem: High Risk Patients

Because only 5% of the population drives 30% of next year's costs, proactively identifying high predicted risk patients and managing their care experience is critical to your success in risk-based contracts and shared savings.  Our Provider Intelligence solution, built specifically for providers, enables providers to prospectively identify patients likely to incur high costs and utilization and then develop interventions to address short and long-term quality improvement and cost containment opportunities.

The Solution: Provider Intelligence

Features

  • Identify, stratify and segment populations with clinical and risk criteria
  • Monitor out-of-network utilization leakage across patient populations
  • Measure efficient use of costly healthcare resources against expected levels using risk models to adjust for population differences
  • Drill down to population, provider group, individual provider and patient-level detail
  • Benchmark cost, quality, and efficiency against national norms

Benefits

  • Manage population health and patient engagement
  • Improve quality of care and compliance with evidence-based medicine
  • Implement P4P incentive programs addressing risk-adjusted variation in efficiency
  • Pinpoint opportunities for near-term savings through referral patterns and medical management
  • Understand and plan for population risk entering risk-based payer contracts

Next Steps

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