Data Analysis and Reporting
Health Care Analytics provides
decision support analysis and management reporting
using your organization’s source data
Medicare Advantage Risk Adjustment &
Revenue Enhancement Analysis
·
Risk
Score Calculation
·
Code
Leakage Analysis
·
HCC
Pattern Analysis
·
RAPS
Return Data Analysis
·
RAPS
submission error reporting & analysis
·
Premium
Revenue Reconciliation
·
Data
Driven Tools for Enhanced ICD9 Coding and Provider Education
HCA will provide
custom analysis and reporting as well as a comprehensive set of
pre-defined decision support and management reports by mapping client
specific data to HCA's proprietary reporting system. These reports will
assist you in monitoring your health care programs as well as analyzing
specific data on health care usage and providers practice patterns. Information
from this comprehensive set of reports can be compared to regional and
national benchmarks so that areas of greatest variability can be targeted
for improvement.
Suites of reports are available in the
following modules:
·
Managed Care Payer
Reporting System: Analysis and Trend Reporting Module
HCA also
designs, develops and produces management reports in the following
modules:
·
Managed Care Payer Reporting System: Operations Reporting
Module
·
Managed Care Provider Reporting System: Analysis and Trend
Reporting Module
·
Managed Care Provider Reporting System: Operations Reporting
Module.
Reports are not
limited to those within the above modules. Ad hoc reports tailored to
your needs can be generated.
Medical Cost Analysis
Rapid
identification of cost increases in medical services is critical to cost
management. Health Care Analytics uses data mining technology and
advanced drill down analytic techniques for PMPM trending via multiple
variable analysis such as major service category, CPT code, ICD-9 code,
DRG, benefit, drug therapeutic class and line of business.
Reimbursement Modeling
With years of
actuarial experience and access to comparative industry data, Health Care
Analytics develops competitive capitation rates & fee schedules, as
well as innovative risk sharing models. Our use of advanced
"What-If" scenario modeling makes it easier to determine and
implement the most cost-effective contracts.
Medical Utilization Analysis
Health Care
Analytics discovers medical management opportunities by analyzing
practice patterns in relation to hospital bed days, office visits,
referral practices, and specialty care procedures. Unnecessary care as
well as under-utilization can be monitored using HCA's specifically
designed medical and case management reports.
Provider Profiling
Health Care
Analytics designs and produces provider feedback mechanisms. These
include case-mix adjusted provider performance measurement reports, customized
practice pattern analysis, and reporting & analysis necessary to
satisfy P4P (Pay for Performance) requirements.
Quality Measurement
Health Care
Analytics designs tools to measure medical outcomes in order to improve
patient or policyholder health status, attract and retain members or
patients, and satisfy regulatory demands such as P4P (Pay for
Performance), HEDIS, QARR, DOI, and DOH reporting.
Data Warehouse Design and
Database Management
Health Care
Analytics designs and develops
custom database management systems including data warehousing and
decision support systems. Our expert IT professionals assist with data
conversion and system integration procedures.
To achieve this, Health Care Analytics has developed
the Meta-Manager© proprietary software tool.
This meta-data management data warehouse development tool is a relational
database management system designed for mapping data elements and lookup
values across multiple systems. Via this tool we are able to accommodate
file layouts for mapping hundreds of legacy systems and an unlimited
number of data elements, provide statistical reports on data element mapping
progress, and handle the mapping of systems with different hierarchical
structures.
Medical
Literature Research
With full access to
thousands of medical journals, Medline and other databases at the
National Library of Medicine, Health Care Analytics is a full service
literature search and abstraction service.
HIPAA
& IT Security
Internet, intranet
and extranet technologies have drastically increased the risk of
industrial espionage and attacks by hackers, both internal and external.
Organizations risk running afoul. Traditionally, hackers view breaking into a system as
mountain climbers view scaling a cliff: it's their next great challenge. Hackers exploit
known network and
system vulnerabilities to attempt to access your information. The Internet greatly
facilitates their nefarious actions. Since hackers employ automated tools that
automatically scan the Internet for weaknesses, no organization is to small or
too obscure to not be at risk. One company thought their computer defenses were ironclad
- that is, until they
received a message from a hacker demanding ransom and threatening to
post the company's
client information on the Internet. The company found out the hard way that they had
one weak link in their chain. HCA offers several network and data security service
offerings. Our most popular is the Due Diligence review that provides a quick report
on any risks that
might exist. Contact us today to learn how HCA can help assure you that your data and network
will remain your own.
H e a l t h C a r e A n a l y t i c s
, I n c.
Phone: (631) 754-9104
Email: info@hca-inc.com
www.hca-inc.com
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