Regardless of the size of the hospital or health system, you need to look beyond traditional operational metrics to fully understand your organization’s performance. Insights into revenue, volume, cost, quality and variation across service lines are key to improving both performance and profitability.

Transforming data into a competitive advantage for health plans is more important than ever. Rapid changes in the healthcare industry—such as new risk models, the uncertainty of the Affordable Care Act and game-changing mergers—are placing new obstacles on payers. The mounting pressure to support these industry transformations and the overall delivery of care has led to increased investments in analytics.

Value-based care remains top of mind for payers and providers alike. However, continued misalignment between payers and providers can hinder their ability to achieve cost and quality goals. A recent Quest Diagnostics study shows that 62 percent of health plan executives feel that payers have made progress in aligning with providers, while only 41 percent of physicians agree with this notion. What’s more, according to an HFMA survey commissioned by MedeAnalytics, an overwhelming 88% of providers say they are not ready for value-based care.

Frequent utilization of the emergency department for non-emergent care remains a chronic challenge for health plans looking to improve costs and quality. Studies show that as much as 5% of the overall patient population seen in the ED accounts for as much as 18% of all annual emergency department visits. In addition, nearly 20% of ED complaints stem from mood disorders, and another 10% relate to alcohol use.

MedeAnalytics was recently highlighted in Gartner’s Market Guide for Healthcare Provider Value-Based Performance Management Analytics (VBPMA). As noted in the guide, value-based performance management analytics solutions are the next-generation financial planning and modeling tools that health systems need to manage performance across volume, value, and risk-based contracts.

This week, MedeAnalytics celebrates our 25th anniversary! Mede has evolved significantly since its revenue cycle beginnings, and through it all, our dedication to helping improve the business of healthcare through smarter decision making has never wavered.

As the 2019 HEDIS season approaches, it’s important to identify the tools that will inject speed and data quality in your chart chase process. With a simplified and streamlined chart chase process, you can save time and eliminate costly inefficiencies—to quickly put high HEDIS scores within reach.

Managing the cost and care associated with chronic conditions remains a top priority for both payers and providers. While conditions like diabetes, heart disease, and asthma account for a significant portion of U.S. healthcare spending, they are often preventable or manageable through lifestyle choices, early detection, and proactive care. As a result, the shift to value-based care has prompted healthcare organizations to look beyond chronic condition management and get the bigger picture on factors affecting their patient populations like identifying opportunities for preventative care.

Value-based care has been top of mind for health systems across the country, but a recent study shows misalignment between payer and provider groups is impacting the industry’s goal of shifting from volume to value. In fact, 62 percent of health plan executives feel that payers have made progress in aligning with providers, while only 41 percent of physicians agree with this notion.

Every year from January to May, payers and providers gather and analyze data to report on the quality of their care. The challenges associated with HEDIS® can be significant. Efficiency issues such as manual claims analysis, individual chart chases, and a lack of centralized data sources can consume valuable time and resources.