Control Utilization

Value Based Care Organizations must appropriately utilize services necessary for their beneficiaries. Overutilization can drive up costs unnecessarily, while underutilization can have the same effect. Primary care physicians and all healthcare facilities traditionally have siloed practices but with the insight into claims and other important clinical information, the user is able to gain insights into how other services are being accessed outside of their facility parameters.

Control utilization: analyzing metrics per 1000 as well as the relative change compared to prior performance is how the Value Based Care Organization can move towards utilization goals.

Our Solution Allows users to:

  • Create actionable, customized lists to share with TINs/providers
  • Identify beneficiaries with high and/or increasing ER utilization
  • Evaluate patterns of ER utilization by attributed TIN or NPI
  • Review ER Utilization Dashboards that based off NYU model (unnecessary) and frequent flyers
  • Determine which intervention strategy is appropriate for each TIN
  • Monitor progress/impact of ER utilization
  • Evaluate Specialists costs and utilization
  • See what other providers are performing primary care services
  • Review IP, SNF and IRF Index Admissions and Readmission Rates
  • Monitor 90 day post acute care episodes