HEALTHCARE PROVIDERS

Health systems, physician groups, clinics, and other provider organizations are engaged in more direct contracting, providing population health programs, and taking on more financial risks in the process.  Predictive modeling and claims analytics provide valuable data and the actionable information they need to address patient needs, quantify the risks, negotiate equitable contracts, develop and improve care programs and demonstrate outcomes and savings.

Health System Data Analytics Services

For health care systems providing services (for example, clinics and accountable care organizations), HCRM can integrate the health system EMR (electronic medical record) patient data with the external claims data. This gives a 360-degree view of all care, not just what is in the EMR. The clinicians see all gaps in care, all medications used by the patient, as well as other diagnoses and treatments. The providers can then use this information to more effectively address patient needs and proactively engage specific members for timely care.

For those involved in direct contracting, the HCRM system allows them to accurately assess the clinical and financial risk of taking on the employer plan and pricing their services. For primary care providers, HCRM can integrate their EMR data with external claims data for a complete picture of patient health.