Service Provider Performance Analytics

Don’t limit your insights to pre–defined aggregates

xtLytics tools enable agile exploration of existing data without burdening IT in the process. xtLytics Big Data Analytics provides a 360­-degree view across all your critical touch points. Using xtLytics, customers can discover new insights across multiple data sets Service Provider Performance Analytics more effectively.

For example, companies can compare the performance of both providers and networks in near real-­time. This information can be used during rate negotiations and when investigating the potential impact of new risk-sharing arrangements with Accountable Care Organization (ACOs). Companies can isolate outliers within the provider network and determine the factors that are driving their performance. If necessary, payers may need to consider changes to their network strategy or member incentives to direct patients to better providers. Companies can share performance data, when possible, with clients and members to encourage greater use of the best-performing providers.

Cost Management

    • Negotiate rates with service providers effectively
    • Analyze cost variability and patients risk distribution to predict future financial expense
    • Cost estimation for the entire continuum of care for high-risk patients by service providers
    • 360-degree view of service provider, physician by specialty, and patients by chronic conditions

Increase Revenue

    • Strategize plan prices using cost trends and population risk
    • Retain customers or market your message based on quality, safety and patient satisfaction

Performance Enhancement

    • Determine factors of performance via analyzing outliers (or excluding outliers) and process change impact on KPI such as LOS (length of stay)
    • Analyze impact on programs such as drug compliance improvement programs on performance
    • Target specific patients to reduce % of non-compliance
    • Reduce readmission rate (shared with Improve cost of care module)
    • Insight into utilization trends to plan future healthcare needs

Benchmarking

    • Establish benchmark by geography for chronic conditions