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Optimize Program Performance

Optimizing performance is more than just reporting and monitoring of your data quality, algorithms or vendor strategies

Optimize Program Performance

To achieve the maximum value from risk adjustment, care management and quality programs, health plans need to understand the opportunity for improvement at the individual and portfolio level. Even more important, health plans need the ability to simulate different strategies and likely outcomes, which will ultimately enable rapid and impactful course-correction.

How we can help

  • Data integration – bring historical financial and membership data together to support sophisticated forecasts and performance projections, including:
  • Impact to revenue and financial performance based on changes to membership or competitive market position
  • Impacts of clinical interventions and member receptiveness to outreach
  • Improvements in quality measure scores
  • Performance improvement – implement tactics to improve performance based on projections and simulations. For example:
  • Automated/streamlined chart retrieval and processing
  • New or enhanced analytical targeting models
  • Adjustments to timing, frequency and method of provider and member engagement