Reduce total cost of care and improve quality with advanced data analytics.
Successful value-based healthcare delivery is predicated on your capacity to improve the quality and reduce the total cost of care at the same time. Clinigence integrates quality data from electronic health records (EHRs) with cost data from claims to give you this capacity.
Clinigence also provides out of the box canned reports that break down the total cost of care by practice and provider, based on (Medicare) enrollment type (disabled, aged dual, aged non-dual and ESRD,) major expense categories (Inpatient, outpatient, Part B/provider, skilled nursing facility, home health, hospice and durable medical equipment.) CMS-HCC risk adjustment scores are calculated for each population.
High Utilizer Reports
Additional "canned reports" include high utilizers of certain services, such as the emergency department and hospital services. You can easily identify high utilizers of any other service of interest as needed.
Cost/Quality Transparency Reports
Cost/quality transparency reports show the average cost/quality indicator by facility and/or by the provider as calculated for your patients. These reports help you assess the value delivered by providers outside your network to your patients. They provide the basis for value-based referral patterns and arrangements.
You can easily create additional reports based on virtually any cost or quality criteria. For example, you can pull up aggregate cost reports by diagnosis-related groups (DRGs,) hierarchical condition categories (HCCs,) diagnoses and procedures, etc.
Cost of Quality Reports
Clinigence is also developing unique "cost of quality reports" in collaboration with our ACO clients. These reports specifically measure the cost-effectiveness of clinical guidelines and protocols.