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.
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.
Analytics is critical for MCOs to support key cost and quality objectives.
Download this resource to explore how data-based strategies can help organizations accomplish important goals and improve existing healthcare services for Medicaid beneficiaries.
MedeAnalytics and Socially Determined partner to provide a more holistic view of patients and members with integrated social determinants of health data
This pivotal partnership paves the way for optimized value-based care through actionable SDOH insights. MedeAnalytics CEO Steve Grieco spoke to the immense benefits stating, "This will allow further risk stratification for focused interventions, leading to better care coordination, patient engagement, cost savings, and stronger, healthier communities."