HEALTH DATA ANALYTICS OPTIMIZED CLINICAL AND FINANCIAL OUTCOMES DELIVERED FOR YOUR POPULATION HEALTH MANAGEMENT PROGRAMS
HOW WE HELP YOU MAXIMIZE THE VALUE OF YOUR POPULATION HEALTH INITIATIVES Indegene s Health Data Analytics solution suite helps your organization address the current challenges of Population Health Management by systematically delivering powerful insights and driving clinical and business outcomes. Indegene Health Data Analytics Suite includes SmartCare, a proprietary validated analytics platform, multiple data integration and management tools as well as clinical and operational services. We currently serve Commercial, Medicare and Medicaid Health Plans, Employers and Health Systems. Our Data help address client challenges such as data integration, normalization and manage complex data challenges. Our Program Management deliver management support that augments your internal resources and help drive clinical and business outcomes. Our Business Intelligence and Reporting Analytics discovers smart patterns and provides the right information at the right time to the right audience. Our Volume-to- Transformation provide insights to support population health management programs and improve outcomes. We operate on a service or subscription model and deliver value to your organization by leveraging our domain expertise, healthcare program management experience and comprehensive analytics capability. DATA SERVICES Acquire and aggregate claims and clinical data from various providers and health plans into a data warehouse using our unique data architecture, ETL, MDM, quality and governance frameworks Quick insights delivered from episodes-of-care Reduced costs and efforts in clinical integration of your clinical and claims data Benefit from critical benchmark comparison Data BI and Reporting Analytics Health Data Analytics Solution Suite Program Management Volume-To- Transformation PROGRAM MANAGEMENT SERVICES Development of Risk Management Plans based on our proprietary Risk Governance (I-RISE) framework for identifying and stratifying risks and discovering opportunities for engagement Provide Quality Management services for defining and monitoring network quality through process accelerators such as checklists, benchmarking reports and utilization metrics, monitor compliance to clinical coding standards and medical record retrievals and track care for chronic and acute conditions Improved Care Quality Cost Optimization Improved Utilization 2 3
BUSINESS INTELLIGENCE AND REPORTING ANALYTICS SERVICES Identify risk, cost, revenue, and quality opportunities through context-based presentation and visualization Streamlined Reporting VOLUME-TO-VALUE TRANSFORMATION SERVICES ACTIONABLE Get actionable insights to support population health management programs and improve outcomes Deploy advanced risk analytics and predictive modeling capabilities to - Identifying at-risk populations and stratify risk using industry standard models (3M's CRG, HHS-HCC, CMS-HCC models) or customized home grown/ in-house models INTELLIGENCE DELIVERED - Stratify patient population and analyse case mix, DRG, SOI and patient mortality in relation to costs - Forecast readmissions - Refine Contract Models - Determine utilization levels - Benchmark and more Brings focus on the patient population where care is needed most Helps identify key quality and cost improvement opportunities Get insights to develop and optimize your Population Health Program strategy 4 5
SAMPLE REPORTS SAMPLE USE CASES Quality Measure Reports Top DRGs by Frequency Report. Top DRGs by Payment Report. Review compliance with clinical Benchmark providers based on Isolate and address EandM Resource Utilization Comparison of a Physician to all guidelines with treatment pattern review. casemix-adjusted comparisons for key metrics such as LOS and coding abuse. Physicians. readmissions for over 30 defined disease treatment protocols. Surgery Categories Distribution Report. Comparison across different datasets Office Visit Coding Patterns, Pap Smear Exams, Wellness Exams, Inpatient Utilization. Identify resource utilization like Analyse casemix, DRG, SOI and Predict next year s charges for Insights from both Structured and Unstructured emergency room visits by PCP to identify potential lapses in care. patient mortality in relation to costs. treating a patient population based on clinical risk groups. datasets. Predictive Modeling Reports Master Severity Distribution Reports. Risk Scoring by PCP, Plan, Region. Risk Distribution by Patient for each PCP and by Region. Plan Membership Reports Overall membership report within specified time range with member months and financials. Patient counts across custom categories. 6 7
ABOUT INDEGENE HEALTHCARE: Indegene's Healthcare delivers Next Generation Solutions For Payers and Providers across Risk Adjustment, Quality Improvement, Population Health Management and Member/Provider Engagement. Indegene leverages its significant capabilities across Analytics, Technology, Operational Scale and Medical Expertise to help Payers and Providers drive better Health and Business Outcomes. Indegene has a strong focus on IP and innovation, with a full portfolio of platforms including HEDISPro and STARMAX for Quality Improvement, RiskOptimizer, ProspectiveEnhance and EncounterPlus for Risk Adjustment, iclinengager and Ngage for Provider and Member Engagement, CareMax for Care Management and SmartCare, an integrated enterprise analytics platform for Population Health Management. 485B Route 1 South, Suite 300, Iselin, NJ 08830. P +1 732 750 2901 F +1 732 750 7990 E healthcare@indegene.com W www.indegenehealthcare.com 2015 Indegene Healthcare. All rights reserved