Healthcare providers continue to recognize the value of using AI in reporting operations throughout the organization. AI has many strengths when applied to the healthcare industry: Automate routine, repeatable data analysis; Create data insights delivered directly to users; Build analytics, such as chatbots; Posit “what if” scenarios; and Identify data clusters, forecasting and anomalies using… Read more »

Business intelligence (BI) was a dramatic and significant step forward in healthcare industry reporting and a natural transition to artificial intelligence (AI) enabled real-time insights. BI is a natural progression in healthcare reporting, and finally, AI becomes the best practice for reporting to access healthcare data and information quickly and easily This installment of MedeAnalytics… Read more »

Many areas in healthcare rely not only on the collection of data but, importantly, the ability to decipher and act upon it. In that intersection, reporting was born.

In October, MedeAnalytics is recognizing Breast Cancer Awareness Month, a worldwide campaign to increase awareness, education and research about breast health and the importance of early detection. Breast cancer is the second most common kind of cancer in women, and one in eight women will get breast cancer in their life time. Through annual screenings… Read more »

Due to rising healthcare costs and the Affordable Care Act removing the ban on capitated benefits coverage, numerous employers with self-insured health plans often purchase stop loss coverage. This coverage is not medical insurance; but rather, it’s a financial and risk management tool that protects the employer from excessive claims. Stop loss is used in… Read more »

Every patient has a plethora of data associated with their health record, which can include decades of enrollments, claims, accounts and charges. Much of this data is not housed within the same institutional, facility or provider database…

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.