Predict & Transform
with
Financial Confidence

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

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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
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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
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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

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Claims Cost

  • Identified sub-optimized processes, care-team performance, and social determinants of health
  • Quantified net savings for improving several processes including physician incentives, patient education, and skilled nursing  facility disposition
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Provider Expense

  • Identified sub-optimized direct variable cost drivers
  • Quantified net savings for improved staffing and sourcing of surgical implants
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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

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
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Complications

  • Identified steps that enable prevention and earlier identification of complications
  • Quantifed net savings for improving several care steps including pre-op planning, anesthesia, pain management, physiological surveillance, and catheter removal
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Functional Recovery

  • Identified opportunities to improve pre-admission conditioning and post-discharge rehabilitation
  • Quantified benefits for improving several care steps including pain management, ambulation, and wound care
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Patient Experience

  • Identified pain measurement and management opportunities
  • Quantified benefits for improving several care steps including patient education, care giver assistance, home health and follow up visitation

Discover Actionable Insights

See a demo of our solution and also learn about our unique Opportunity Analysis report

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