Jun 9 2010
Health plans, health management programs and healthcare providers can more accurately identify members, employees and patients who may benefit from targeted care management using the latest version of DSTHS CareAnalyzer®. Released today by DST Health Solutions, LLC, CareAnalyzer 4.1 is a comprehensive analytics software solution combining elements of patient risk, care opportunities and provider performance that helps organizations improve care management and meet reporting requirements for the Healthcare Effectiveness Data and Information Set (HEDIS).
CareAnalyzer 4.1 builds on the strengths of DST Health Solutions' profiling capabilities to help health plans identify providers who are less effective at delivering efficient, high quality care. Health plans can detect providers with costly or unusual referral patterns and submit outlier providers for further investigation.
"With the onset of healthcare reform, it will be imperative that health plans have sophisticated analytics to measure provider effectiveness," said Amy Salls, business solutions executive of decision support and analytics, DST Health Solutions. "CareAnalyzer 4.1 allows health plans to identify and stratify populations where we can have the greatest impact by identifying members with chronic conditions who are at risk for low adherence to prescription regimens, who have poor coordination of care among providers, who have not met recommended preventive care practice guidelines and ultimately as a result, who are at risk for future hospitalization."
Stratifying populations by risk profile allows for more targeted and effective interventions with individual members. Ultimately, this type of analysis supports many goals of healthcare reform, including identifying populations with special needs, determining the impact of medical homes, identifying disparities and determining provider payment based on risk and effectiveness.
Many of these strategies are being pursued by health management services providers, such as Focused Health Solutions of Deerfield, Ill., which is using CareAnalyzer 4.1 to help employers lower healthcare costs and improve employee health.
"With CareAnalyzer, Focused Health Solutions (FHS) has turbocharged its data mining and analytics capabilities, enabling our clients to maximize ROI from their FHS designed population health management programs," explained Michael Taylor, executive vice president at Focused Health Solutions. "Its powerful identification capabilities and gaps in care profiling tools enable us to work with our client data to stave off unnecessary medical costs by proactively identifying high-risk patients for focused intervention."
Source:
DST Health Solutions, LLC