Solutions

Patient Flow

MedInsight Patient Flow

Patient Flow explores the connections observed between healthcare providers as they deliver care. Using traditional medical claims sources, potential connections between providers are identified when a patient visits two providers within a short period of time. The specific connections included in the results are nuanced by provider specialty to focus on plausibly causal connections (e.g. primary care physicians generate many connections while laboratories do not). The resulting web of relationships can be used to understand how patients are flowing through the healthcare system.

Key Use Cases

  • Help steer patients to certain providers (and away from others)
  • Help keep patients away from out-of-network providers
  • Follow patients on their post-acute care journey
  • Understand the impact of real world geography

Key Features

  • Infer network of provider connections from standard medical claims data
  • Present results on an interactive map
  • Drill down to what services patients were receiving as they flow between two specific providers
Conditions to Consider

Conditions to Consider

Point of Care Dashboard

Conditions to Consider uses machine learning to understand the disease state of a population. Results can be used to analyze HCC risk scores or to identify patients at heightened risk of developing chronic diseases. The Point of Care Dashboard is focused for use in a point of care setting.

Key Use Cases

  • Print a patient's existing conditions and conditions to consider for evaluating at the point of care
  • Improve patients' quality of care

Key Features

  • Easy to use
  • Print a single sheet of paper specific to each patient
Conditions to Consider

Conditions to Consider

Financial Dashboard

Conditions to Consider identifies and leverages similarities between patients within a population to ensure appropriate patient morbidity is reflected in risk-based contracts. Similarity is defined based on a patient’s demographic information, medical conditions, and prescription history. It uses collaborative filtering analytics, a common approach among online retailers that leverages these elements like purchase history to identify similar shoppers. The Financial Dashboard focuses on financial impacts.

Key Use Cases

  • Identify similarities in patients to potentially identify conditions
  • Assign appropriate risk scores for patients
  • Identify patients who have been coded with a condition in prior years but have not yet been coded in this financial year

Key Features

  • Filter the population based on the desired focus
  • Display a potential risk score change at the population and patient level
Care Coordinator Report

Care Coordinator Report

The Care Coordinator Report provides care managers with a comprehensive view of recent patient clinical and claims activity, making management more efficient and effective. The Care Coordinator Report allows care managers to strategically select and manage patients for the best opportunity to reduce potentially avoidable cost.

Key Features

  • Prediction of healthcare costs over next six months
  • Identification of clinical and non-clinical drivers of estimated costs
  • Reporting of historical utilization
  • Episodes of care reporting
  • Flags potentially avoidable costs

Key Benefits

  • Improve care coordination
  • Optimize care management investment
  • Identify cost drivers outside system
  • Reduce cost and effort of each care coordination encounter
Cost Model Dashboard

Cost Model Dashboard

The Cost Model Dashboard is a financial utilization tracking tool to identify trends in spending and utilization. The Cost Model Dashboard allows users to 'slice and dice' financial data across multiple data dimensions.

Key Features

  • Summary of data by actuarial cost model
  • Ability to segment data by cost model group, demographic information, or clinical condition
  • Reporting of total healthcare cost, cost per member per month, or utilization metrics

Key Benefits

  • Quickly identify trends in data and enrollment
  • Visualize and drill into claims or demographic data at desired population or service level
  • Filter the population in order to display information at the segment level
  • Compare cost and utilization among sub segments of a population

Milliman consulting is focused on you.

We collaborate with you to provide customized services that specifically identify and address your critical business issues.

Request a Demo