Aggregation

  • Aggregation
  • Interpretation
  • Transformation

Our powerful healthcare analytics solutions not only respond to today’s pressing issues—like fee-for-value, expanding Medicaid benefits and accountable care—they make possible proactive, evidence-based management of the challenges and opportunities in today’s health care paradigm. 

Learn more about our platform

For Healthcare Providers

  • Patient Access Patient Access provides critical real-time analytics information during the patient registration and payment clearance processes. With intuitive dashboards and simple step-by-step checklists, front office staff are able to accurately estimate patient cost, improving pre-service collections and reducing back end denials.
  • Revenue Integrity Healthcare reimbursement is changing. By 2020, fee-for-value reimbursement is projected to represent 83% of your revenue—up from 43% today and 14% in 2010. Clinical operations will become vital to your bottom line. It is at the mid-cycle—the point between patient access and the business office—where improvement initiatives will have the greatest impact. Revenue Integrity gives you complete visibility into documentation and coding performance—and that of your peers. So you can quickly spot opportunities to improve revenue capture, minimize audit risk, and measure and monitor the impact of ICD-10 on your revenue.
  • Business Office To ensure your financial viability, you need insight into the revenue cycle so you can boost cash collections, reduce bad debt, stop denials, enhance productivity, and guide business strategy. Business Office provides the analytics you need to identify revenue bottlenecks and manage reimbursement trends so you can focus your resources on what matters most: providing quality patient care.
  • Population Health for Providers The powerful Population Health analytics tool provides unmatched insight into understanding high-risk patient populations. By aggregating data on costs, quality and efficiency measures across multiple sources, it proactively identifies gaps in care and segments at-risk populations, cutting clinical costs and ensuring viability in a fee-for-quality system.
  • Performance Management Performance Management combines robust analytics with action planning, resource assignment, progress tracking and performance monitoring—all in one closed-loop performance improvement system—to ensure the organization is on the same page at the same time, working toward the right goals and achieving the best possible results.

For Health Plans

  • Provider Engagement Our Provider Engagement solution brings a whole new level of health plan - provider transparency. By giving a critical view into the claims life cycle, provider networks and value-based contracts, health plans can collaborate with providers to identify the root causes of underperformance, and pinpoint what’s driving high-performing partners as well. Not only does that mean fewer appeals and errors, it means greater member satisfaction and more transparent provider relationships.
  • Population Health Population Health reveals the clinical opportunities that lead to healthier populations. Integrating claims, clinical and provider data, it enables health plans and providers to collaboratively deliver on the promise of risk- and value-based contracts.
  • Medical and Medicaid Management Medical & Medicaid Management helps you identify critical patterns and correlations that reveal exactly where to find savings. By pinpointing areas to take strategic action, mitigate catastrophic claims and promote better health, health plan staff gain an improved understanding of cost and quality drivers and at-risk populations—fully equipping them to steer quality, timely care toward their highest cost members.
  • Employer Reporting Employer Reporting provides collaborative, modern health care analysis and reporting that increases employer retention, reduces strain on internal reporting staff, and improves client satisfaction. Employer Reporting integrates with MedeAnalytics’ full enterprise suite.
  • Enterprise Master Patient Index MedeAnalytics Enterprise Master Patient Index (EMPI) creates a single patient record and ensures that patients are represented only once across all systems. It integrates claims and clinical data and uses sophisticated algorithms to enhance patient data accuracy and improve the continuity of care.
  • HEDIS Quality Management MedeAnalytics HEDIS Quality Management provides scalable, quality reporting with speed, frequency, and analytics power unmatched in the industry. Plans benefit from measures that may be updated as often as daily, integration with a platform that enables member-level granularity and custom measures matching plan requirements. All results are fully auditable and traceable.
  • Performance Management Performance Management combines robust analytics with action planning, resource assignment, progress tracking and performance monitoring—all in one closed-loop performance improvement system—to ensure the organization is on the same page at the same time, working toward the right goals and achieving the best possible results.
  • Patient Engagement & Satisfaction

    In a new, patient-centric healthcare model, quality is measured both clinically and experientially, making patient satisfaction a lynchpin for maximizing reimbursement. When everything impacts the patient experience, you have to examine every opportunity to improve it. Analytics are the critical toolset for sorting through the vast array of patient data from which key satisfaction drivers can be discerned – accurate estimates of self-pay costs, precise and timely billing, key clinical opportunities to improve care and many other ways to make healthcare a better experience.

    • Patient Access

      Patient Access provides critical real-time analytics information during the patient registration and payment clearance processes. With intuitive dashboards and simple step-by-step checklists, front office staff are able to accurately estimate patient cost, improving pre-service collections and reducing back end denials.

    • Employer Reporting

      Employer Reporting provides collaborative, modern health care analysis and reporting that increases employer retention, reduces strain on internal reporting staff, and improves client satisfaction. Employer Reporting integrates with MedeAnalytics’ full enterprise suite.

    • Provider Engagement

      Our Provider Engagement solution brings a whole new level of health plan - provider transparency. By giving a critical view into the claims life cycle, provider networks and value-based contracts, health plans can collaborate with providers to identify the root causes of underperformance, and pinpoint what’s driving high-performing partners as well. Not only does that mean fewer appeals and errors, it means greater member satisfaction and more transparent provider relationships.

    • Population Health

      Population Health reveals the clinical opportunities that lead to healthier populations. Integrating claims, clinical and provider data, it enables health plans and providers to collaboratively deliver on the promise of risk- and value-based contracts.

    • Population Health for Providers

      The powerful Population Health analytics tool provides unmatched insight into understanding high-risk patient populations. By aggregating data on costs, quality and efficiency measures across multiple sources, it proactively identifies gaps in care and segments at-risk populations, cutting clinical costs and ensuring viability in a fee-for-quality system.

  • Clinical Quality & Safety

    In an outcomes-driven healthcare environment, quality is as much about prevention as it is treatment. MedeAnalytics provides both health plans and providers with solutions that help inform clinical operations across the continuum of care, creating efficiencies, preventing readmissions and reducing avoidable costs while ensuring fee-for-performance viability.

    • Population Health

      Population Health reveals the clinical opportunities that lead to healthier populations. Integrating claims, clinical and provider data, it enables health plans and providers to collaboratively deliver on the promise of risk- and value-based contracts.

    • Population Health for Providers

      The powerful Population Health analytics tool provides unmatched insight into understanding high-risk patient populations. By aggregating data on costs, quality and efficiency measures across multiple sources, it proactively identifies gaps in care and segments at-risk populations, cutting clinical costs and ensuring viability in a fee-for-quality system.

    • Medical and Medicaid Management

      Medical & Medicaid Management helps you identify critical patterns and correlations that reveal exactly where to find savings. By pinpointing areas to take strategic action, mitigate catastrophic claims and promote better health, health plan staff gain an improved understanding of cost and quality drivers and at-risk populations—fully equipping them to steer quality, timely care toward their highest cost members.

  • Payment Reform & Value-Based Purchasing

    Better patient outcomes at lower costs require an intimate grasp of the total episode of care, including opportunities for improvement and intervention. MedeAnalytics’ solutions bring both health plans and providers the insight—and evidence—to find the perfect balance between spending and driving optimal clinical results.

    • Population Health

      Population Health reveals the clinical opportunities that lead to healthier populations. Integrating claims, clinical and provider data, it enables health plans and providers to collaboratively deliver on the promise of risk- and value-based contracts.

    • Population Health for Providers

      The powerful Population Health analytics tool provides unmatched insight into understanding high-risk patient populations. By aggregating data on costs, quality and efficiency measures across multiple sources, it proactively identifies gaps in care and segments at-risk populations, cutting clinical costs and ensuring viability in a fee-for-quality system.

    • Provider Engagement

      Our Provider Engagement solution brings a whole new level of health plan - provider transparency. By giving a critical view into the claims life cycle, provider networks and value-based contracts, health plans can collaborate with providers to identify the root causes of underperformance, and pinpoint what’s driving high-performing partners as well. Not only does that mean fewer appeals and errors, it means greater member satisfaction and more transparent provider relationships.

    • Business Office

      To ensure your financial viability, you need insight into the revenue cycle so you can boost cash collections, reduce bad debt, stop denials, enhance productivity, and guide business strategy. Business Office provides the analytics you need to identify revenue bottlenecks and manage reimbursement trends so you can focus your resources on what matters most: providing quality patient care.

  • Health Plan / Provider Transparency

    With today’s fee-for-value models, both health plans and providers have a stake in providing better care at a lower cost. Not only does this take cooperation, it takes collaboration. Our solutions facilitate an unprecedented level of mutually beneficial transparency between health plan and provider to aid this critical relationship.

    • Provider Engagement

      Our Provider Engagement solution brings a whole new level of health plan - provider transparency. By giving a critical view into the claims life cycle, provider networks and value-based contracts, health plans can collaborate with providers to identify the root causes of underperformance, and pinpoint what’s driving high-performing partners as well. Not only does that mean fewer appeals and errors, it means greater member satisfaction and more transparent provider relationships.

    • Population Health for Providers

      The powerful Population Health analytics tool provides unmatched insight into understanding high-risk patient populations. By aggregating data on costs, quality and efficiency measures across multiple sources, it proactively identifies gaps in care and segments at-risk populations, cutting clinical costs and ensuring viability in a fee-for-quality system.

  • Cost Reduction & Process Improvement

    There are countless ways to lower costs and improve the way healthcare is delivered, an increasingly critical issue as more and higher risk patients gain access to treatment. The right analytics address this juggernaut in multiple ways: classifying high-risk populations for intensive—and preventative—care management, improving estimating accuracy and collection rate of self-pay patients, as well as creating visibility into the referral stream.

    • Population Health

      Population Health reveals the clinical opportunities that lead to healthier populations. Integrating claims, clinical and provider data, it enables health plans and providers to collaboratively deliver on the promise of risk- and value-based contracts.

    • Population Health for Providers

      The powerful Population Health analytics tool provides unmatched insight into understanding high-risk patient populations. By aggregating data on costs, quality and efficiency measures across multiple sources, it proactively identifies gaps in care and segments at-risk populations, cutting clinical costs and ensuring viability in a fee-for-quality system.

    • Medical and Medicaid Management

      Medical & Medicaid Management helps you identify critical patterns and correlations that reveal exactly where to find savings. By pinpointing areas to take strategic action, mitigate catastrophic claims and promote better health, health plan staff gain an improved understanding of cost and quality drivers and at-risk populations—fully equipping them to steer quality, timely care toward their highest cost members.

    • Employer Reporting

      Employer Reporting provides collaborative, modern health care analysis and reporting that increases employer retention, reduces strain on internal reporting staff, and improves client satisfaction. Employer Reporting integrates with MedeAnalytics’ full enterprise suite.

    • Provider Engagement

      Our Provider Engagement solution brings a whole new level of health plan - provider transparency. By giving a critical view into the claims life cycle, provider networks and value-based contracts, health plans can collaborate with providers to identify the root causes of underperformance, and pinpoint what’s driving high-performing partners as well. Not only does that mean fewer appeals and errors, it means greater member satisfaction and more transparent provider relationships.

    • Business Office

      To ensure your financial viability, you need insight into the revenue cycle so you can boost cash collections, reduce bad debt, stop denials, enhance productivity, and guide business strategy. Business Office provides the analytics you need to identify revenue bottlenecks and manage reimbursement trends so you can focus your resources on what matters most: providing quality patient care.

    • Patient Access

      Patient Access provides critical real-time analytics information during the patient registration and payment clearance processes. With intuitive dashboards and simple step-by-step checklists, front office staff are able to accurately estimate patient cost, improving pre-service collections and reducing back end denials.

Consulting Services

  • Consulting Services For Healthcare Providers

    We don’t just sell tools—we offer fully integrated solutions. Our expert consultants are armed with extensive industry experience in process improvement, performance management and technology implementation. That means, not only do they have the insight to help you develop impactful strategies based on analytic evidence, they also possess the know-how to implement them effectively. Whether it’s realizing improvements in quality or anticipating cultural shifts, our consultative services are true collaborations rooted in transparency and consistently exceed expectations.

  • Consulting Services For Health Plans

    We don’t just sell tools—we offer fully integrated solutions. Our expert consultants are armed with extensive industry experience in process improvement, performance management and technology implementation. That means, not only do they have the insight to help you develop impactful strategies based on analytic evidence, they also possess the know-how to implement them effectively. Whether it’s realizing improvements in quality or anticipating cultural shifts, our consultative services are true collaborations rooted in transparency and consistently exceed expectations.