Healthcare Data Analytics Blog

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

The Patient-Centered Medical Home (PCMH) model emerged in response to the recognized need for more systematic and evidence-based approaches to ensuring access to, and coordinating care for, an entire population. Within that framework an additional focus has developed that recognizes the specific needs of members with chronic and complex conditions. In order to respond to … Using Data in AICU/IOCP Models

Up until now, the integration of claims data and EHR data has been an often sought, but seldom realized goal in the healthcare analytics world.  It’s a business intelligence idea with so much potential benefit, and it seems like it just wouldn’t be that hard to do. In reality, unifying these two types of data … Poised for Breakthrough: Integrating Claims Data and EHR Data