Healthcare Solutions

Analytics are leveraged by healthcare payers and providers making it possible to collaborate in a way that was never possible before, to develop strategies that benefit both and more importantly, the patient, by providing actionable insights at the organization, provider and patient levels.

Visual analytics facilitate a conversation using data that is shared between Health Plans and their business partners, including Pharmacies, Labs, and Provider organizations, to gain a deeper understanding of clinical and quality outcomes, quality measures, performance using industry benchmarks, cost and utilization patterns, risk score trends and ways to interact with members that benefits everyone in the healthcare continuum.

RefinedBI is focused on helping your organization through the design, development and adoption of the best solutions in the market to drive improvement in revenue, quality, and patient outcomes using actionable data from data sources that we grew up on to deliver measurable value to your business.

Our approach is not to deliver a one size fits all solution, we understand healthcare at a deep level, sometimes you needs revolve around a particular project or analysis of a specific dataset, and we are uniquely positioned to work with you in those important projects.

Read on to learn how we have helped organizations, just like yours to address critical business challenges.

Population Health Outcomes

Providers use Pop Health analytics to improve quality of care to enable superior patient and population health outcomes that:

  • Craft predictive analytics algorithms to stratify patients based upon risk of specific diseases for care coordination and tailored intervention strategies

  • Identifying high risk patients for post-discharge intervention

  • Improve patient throughput and/or case start and discharge times

 

  • Track physician referrals to enable focused physician outreach

 

  • Enabling business analysts to analyze quality variance as a basis for remediation

Designing Care Programs based on Patient Quality data

30 Day Readmission Rates

Gain insights that generate improvements:

  • Improved physician scheduling savings

  • Cardiovascular length of stay (LOS) lowered by 50% against benchmarks

  • 30 day re-admission rates for heart failure and heart attacks reduced by 10 and 12 % respectively

  • Improvement in Patient satisfaction scores

  • Gain insights into utilization at hospital to quickly identify areas for improvement

  • Understand your Payor mix

  • Stay on top of Quality programs and metrics that impact your organization

Reducing Hospital Readmission Rates

Revenue Management

Payor organization advanced analytics for better:

  • Understanding of member Risk Score trends

 

  • HCC analysis that drive strategic Provider initiatives

 

  • Figuring out which services have the biggest impact on Cost, Pharmacy, and Utilization metrics

  • Impact on patient outcomes, and identifying areas that need attention to impact CMS incentive programs

ACO Savings & Losses

Quality Management

NCQA and URAC Accreditation Ratings and Quality Improvement are critical for Health Plans:

  • Gain better insights into current and forecasted Star Ratings

  • Compare against Industry benchmarks

  • Establish Quality baselines

  • Identify the best Intervention mechanisms to drive measure compliance

  • Understand when to intervene with every member based upon historical data and member behavioral information

Design Care Programs based on Quality data

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