Value-based Care Insights-seamless

Value-Based Care Insights

Incentivize partnership in care delivery and patient outcome improvement

As healthcare costs continue to rise and consumers demand greater value, alternative care models are taking on new urgency. For value-based care to be successful, payers, providers and community supports must be engaged and recognize the benefits for themselves and the patients they serve.

To do that well, organizations must ensure that adequate provider networks are in place, providers are measured on quality and cost performance, and reimbursement is based on multiple at-risk and shared savings models to promote higher quality of care at a lower cost. The final key to success is the ability to monitor, analyze, benchmark and improve performance across the ecosystem to exceed value-based care and patient outcome goals.

Comprehensive support for your top value-based care priorities

Value-Based Care Insights enables healthcare payers and providers to improve patient outcomes and satisfaction by delivering higher-quality care at a lower cost. By integrating clinical and claims data, payer and providers gain a 360-degree view into patient/member health that enables actionable insights into population health and risk, provider network performance, and provider quality and measurement.

Program administration

  • Program design and definition
  • Payment model
  • Contract modeling and forecasting
  • Contract operations
  • Timely reporting

Population health management

  • Risk Adjustment
  • Population Attribution
  • SDOH / health equity influences
  • Care gap identification
  • Patient education

Network optimization

  • Risk adjustment
  • Provider attribution
  • Provider efficiency
  • Network leakage
  • Care coordination / transition

Performance reporting

  • Clinical measure management
  • Provider dashboards
  • Cost & utilization metrics
  • Patient / member satisfaction
  • Financial risk management

Payment & invoicing

  • Funding pool management
  • Flow of funds management
  • Deposit account updates
  • Rate & Plan management
  • Provider payment reconciliation

Stakeholder engagement

  • Provider consent management
  • Patient engagement
  • Consumer marketing
  • Consulting services
  • Provider engagement

Augmented analytics

  • EMPI / patient matching
  • Propensity scoring
  • Provider indexing
  • Opportunity index
  • Forecasting

Data & interoperability

  • “Payvider” complexities
  • Interoperability 
  • Integrated dataset management
  • EMR Integration
  • Unstructured data

Analytics in action

Our intelligent platform and intuitive user interface make it easy to unlock the value of your data.

In just three clicks, you can access meaningful insights, powerful visualization, and analytics innovation to help you make an even bigger impact.

Dive deeper into Value-Based Care Insights

Engage provider and patient stakeholders

  • Artificial Intelligence (AI) tools to rapidly surface key trends
  • Seamless connectivity into complementary care management programs to optimize performance​
  • Participant marketing and activation via multi-modal integrated engagement platform
  • Augmented analytics and data science focusing resources on greatest areas of opportunity
  • Provider onboarding automated and at scale
Create high-performing networks
Drive value with performance reporting
Extend holistic value-based care with SDOH
Manage population risk and health
Improve program administration

Leading organizations; exceptional accomplishments

Kaiser reduced ad-hoc report turnaround times by 80% with a 6-month payback

Large California Payvider

This payvider had a wealth of data, but it was separated into varying data systems and departments, reducing its flexibility and effectiveness. With MedeAnalytics, this organization saw incredible reductions in turn-around-times, including an 80% reduction in TAT on ad-hoc reports for healthcare analysis and reporting. By combining clinical and claims data with the advanced analytic capabilities, they demonstrated the ability to solve some of healthcare's toughest challenges.

Kaiser reduced ad-hoc report turnaround times by 80% with a 6-month payback
West Coast In-Home Care Payvider reduced readmissions by 40%

West Coast In-Home Care Payvider

Powered by MedeAnalytics capabilities and platform, this innovative ‘payvider’ used predictive analytics to stratify risk, assess cost and utilization patterns, and improve care for the most complex segment of the population.

West Coast In-Home Care Payvider reduced readmissions by 40%

Visit our Value-Based Care Blueprint page for everything you need to know to navigate the intersection of value and analytics.

Get our take on industry trends

Why Health Plans and Employers Need Stop Loss Reporting

September 10, 2019

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.

Read on...

Bridge the Payer/Provider Data Gap

August 23, 2019

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…

Read on...

Digging deeper: Leveraging analytics to boost service line profitability

June 19, 2019

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.

Read on...

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