Healthcare Economics

Identify the patterns that reveal savings.

Crucial to the success of any health plan is analyzing healthcare economics and understanding high-cost members to steer them toward quality, timely care. Healthcare Economics pinpoints patterns and correlations that reveal opportunities for savings. It enables you to take strategic action, mitigate catastrophic claims, promote better health, and gain insight into costs, quality drivers, and at-risk populations.

  • Analyze healthcare economics

  • Identify high-risk members for care management

  • Offer self-service analysis to medical management staff

  • Measure utilization across various service categories

  • Focus efforts on areas most likely to achieve organizational goals

  • Share performance metrics across the organization

  • Aggregation

    Medical and pharmacy claims, membership, authorization, and care management data provide a comprehensive view of everything from strategic economic issues to specific care management opportunities.

  • Interpretation

    Predictive analytics identify opportunities for intervention and prevention.

  • Transformation

    Share insights with plan staff and providers to organize, prioritize, and target care to reduce both risk and cost.

Identify chronic members in need of improved care.

Identify chronic members in need of improved care.

Target specific interventions to improve cost and quality.

Target specific interventions to improve cost and quality.

What It Offers

  • Healthcare economics
  • Care management
  • Identification and stratification
  • Medical policy guidance
  • Data democracy
  • CM/DM program effectiveness
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