Healthcare Data Analytics Blog

As the cost of healthcare continues to rise, both payers and providers continue the “triple aim” of delivering effective quality care while managing their costs. Value based care (VBC), or value based reimbursements, has emerged as an effective mechanism for achieving this goal. In fact, based on estimates developed by National Business Group on Health, … Reporting Framework for Value Based Care

With over 77,000 codes, ICD10 diagnosis codes provide a much needed level of granularity for clinicians to use in caring for patients, but they are not particularly useful for large scale analytics. As a result, analysts have developed many different diagnostic groupers to group ICD10 codes into meaningful categories for analysis. Several are available within … Chronic Condition Analysis: Selecting a Diagnostic Grouper

Incomplete Provider Data Provider level analysis is extremely important for ACOs. ACOs need to know which providers both within and outside the ACO network are providing services to patients attributed to the ACO. This is important not only to work towards bringing a larger percentage of services in-network (leakage management), but also for quality and … Data Confidence for ACOs

Practical Analytic Approaches to Healthcare Challenges Python is a very popular coding language for doing predictive modeling and data science. We have been discussing python as part of our ongoing Predictive Analytics podcast series for the Society of Actuaries. Four episodes are available for listening now: Episode 1: This is the first of a few podcasts … Doing Predictive Analytics with Python: Podcast Series

Practical Analytic Approaches to Healthcare Challenges Medicare Advantage plans have long recognized the importance of coding to ensure accurate risk scores and clinical documentation. By contrast, Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) often focus less on the implications of risk adjustment or assume they have little ability to affect … The increasing relevance of risk scores on MSSP ACOs