Health Care1

Population Health Analytics

Healthcare systems serve thousands of members and have millions of encounters every year. Each encounter contains valuable data points that can be harnessed to improve outcomes and reduce per member, per month cost of care. In the journey to population health management, healthcare systems today are struggling with the following types of questions:

Who are my high risk members likely to need proactive care management and case management services to prevent high cost encounters?

What chronic conditions are prevalent in my patient population and where are the demand and supply imbalances in my network?

What clusters within my member population are driving up costs?

What gaps within my network are causing members to seek care out of network?

How are my disease management programs performing relative to targets?

Quantiphi population health analytics helps healthcare systems gain data driven answers to these type of questions and provides clear and actionable recommendations to better manage population health.

Incentive Linked Payment Optimization

We are experiencing a dramatic increase in the amount of healthcare payments linked to quality measures. In a historic announcement, HHS has set clear goals and timeline for shifting medicare reimbursements linked to quality. This transformation is reconfiguring over $1 trillion in healthcare spend designed to reward quality, rather than quantity of care.

There are over 300 performance measures that monitor patient experience, health outcomes, process of care, cost of care and patient safety. Healthcare providers today are faced with the challenge of prioritizing focus on the right set of measures that will have the maximum positive impact on the communities they serve.

The solution helps healthcare organizations gain hassle free access to over 300 publicly reported performance measures all in one place. It also helps  pinpoint the handful of measures that will drive the maximum impact to incentive linked payments. Further, it allows organizations to run scenarios and sophisticated sensitivity analysis to determine realistic and achievable goals that will maximize benefits within capacity and budgetary constraints. Armed with clear priorities, your care redesign teams can focus on measures that will that will have the maximum positive impact on the communities you serve.