Healthcare Data Analytics Blog

Healthcare spending in the United States far exceeds that in other developed countries and the American health care system is widely recognized as wasteful. The Congressional Budget Office has concluded that up to 30 percent of the healthcare in the U.S. is unnecessary. Such estimates of waste are generally based on aggregate data such as … Eliminating Waste in the Healthcare System

In our series of blog postings on the topic of Population Health Management, we have discussed how to define populations in Analytics for Population Health Management, and we have looked at the types of analytic tools available for analysis of populations in

For many reasons, including the advent of the Affordable Care Act, Population Health Management is gaining increased attention from healthcare organizations. A population health initiative has the promise to make care proactive, better coordinated and more customized for the population. A previous blog posting – Analytics for Population Health Management – outlined how populations are … Identifying Appropriate Metrics For Population Management

As more and more states create APCDs, their uses are expanding and evolving. Data generated by APCDs are being used to generate disease, injury, chronic condition, and utilization rates across demographic and geographic settings, as well as by payer type.  States are also contemplating linking administrative claims data with clinical data in order to better … PHI and APCDs

Data quality is the foundation of any data warehouse. As the old saying goes “garbage in – garbage out.”  If there are inconsistencies or irregularities in the data loaded into a data warehouse, all analyses based on those data are potentially flawed. Healthcare data are complex, and even data from organizations well experienced in claims … Managing Data Supplier Relationships to Ensure Quality

The use of risk adjustment in provider reimbursement arrangements has increased as alternative payment arrangements are becoming more widespread in health insurance. Risk adjustment has been used by Medicare Advantage and managed Medicaid plans to reimburse health plans for the unique risks and populations in their care. More recently, as carriers have transferred utilization risk … Risk Adjustment for Pediatric Populations