Healthcare Data Analytics Blog

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

Rationale for Developing the Initial 20 Measures The concepts for the measures for the newest MedInsight product, the Health Waste Calculator, were identified from various publications about avoidable healthcare, medical waste, and Choosing Wisely. The team identified an initial list of 134 measures to develop. The prioritization of the initial 20 waste calculator measures, version … Analyzing Healthcare Efficiency Using MedInsight’s Waste Calculator

Over the last few years one day hospital stays have been a focal point for medical management efforts to convert these to observation stays. In addition the 2014 Medicare’s Inpatient Prospective Payment System’s final rule on inpatient admission defines an “appropriate” inpatient admission as one that in the judgment of the admitting physician requires a … Observation Status – A Practical Approach to Evaluating Utilization