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Healthcare Payer Analytics Software Solutions

Digitize Healthcare Data with Healthcare Payer Analytics

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Healthcare Payer Analytics

There are roughly 1,200 healthcare payer companies in the United States. All these payers face the same challenges – increasing their customer base, surviving in a competitive space, incorporating new health plans, and reducing organizational costs. With the help of data analytics, healthcare payers can not only resolve these problems but also increase revenue and improve efficiency.

Through customized healthcare payer data analytics, healthcare payers can determine areas of improvement in patient care and implement innovative strategies to engage high-risk patients. Advanced data visualization techniques enable healthcare administrators to make intelligent business decisions that significantly impact the organization’s performance and revenue.

THE GROWING CHALLENGES

The common bottlenecks which might slow down your business growth

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Redundant Health Plans

Stringent processes of reporting and systems that are not measuring up to the evolving reforms in the healthcare industry.

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Claims Frauds

Low quality measuring systems and tracking puts a strain on the revenue stream due to the increasing number of frauds.

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Unstructured Data

Scattered and disorganized data proves to be meaningless and a burden on payer organizations, without offering any analytics.

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Low Quality Legacy Systems

The existent analytics technology is not able to cope with the huge volumes of data and therefore proves to be useless.

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Low Level Interoperability

Old systems lack the potential to offer interoperability between physicians, clinics, administrative staff and patients for holistic analysis.

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Evolving Regulations

Constantly changing reforms and regulations lay an added burden on healthcare payer organizations, as systems struggle to keep up.

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HOW OSP WORKS

Quality Measurement through Healthcare Payer Analytics Solutions

Process unification of clinical and financial data through effective measuring and reporting analytics

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Solutions

Collaborative Analytics

Healthcare professionals acknowledge that collaboration between different care teams is essential, but lack of time for meetings and unreliable communication solutions restrict interprofessional collaboration.

Through collaborative analytics, clinics, payers, and patients can achieve better interoperability and improve patient experiences. Healthcare payer analytics solutions provide a collaborative framework that promotes information sharing and analysis distribution for the collection and management of patient data across providers, shifts, and locations efficiently.

Economic Analytics

Another useful feature of healthcare payer data analytics is economic analytics. Economic analytical systems analyze the historical economic and financial data of the payer organization. Data analytics solutions provide valuable insights into the costs involved, the quality areas, and populations at-risk, through pattern identification.

Healthcare payers can reduce the risk of fraud and revenue loss by utilizing accurate, timely, and comprehensive economic analysis that follows easy-to-use standardized theories.

Reporting Analytics

Healthcare payer data analytics embedded with reporting analytics allow payer companies to collect, report, and intelligently visualize data.

Reporting analytics can help healthcare payers improve organizational process efficiency through easy-to-follow performance metrics and reports. 

Traditional reports generally display data in a tabular or columnar format. Reporting analytics, on the other hand, present information graphically and through multiple interactive reports. So, the user can create different views and discover meaningful patterns in critical healthcare data.

Organizations can lessen patient wait-times by using healthcare payer data analytics to monitor and leverage scheduling and staffing procedures with minimal errors and enhance employee satisfaction.

Provider Analytics

As the healthcare industry transitions from volume-based care to value-based care, a robust provider network is imperative for better patient outcomes. Provider analytical tools offer compelling visualizations that aid in identifying and fulfilling future business opportunities, improving process and cost inefficiencies, and increasing productivity and revenue.

Healthcare payer data analytics helps in profiling and monitoring provider practice patterns and assessing bundled payments and risk-based arrangements. So healthcare organizations can partner with high-value providers aligned with their cost and quality initiatives and enhance quality care.

Population Analytics

Population Analytics gathers and analyzes population health data that helps healthcare payers recognize at-risk populations and their care needs. These solutions also assess the quality of care provided and aid in the delivery of appropriate care. 

 

This element of healthcare payer data analytics provides comprehensive, reliable, and timely metrics, reports, trends, and graphs. These are designed by data obtained from multiple sources inside and outside the organization on patients and populations.

 

Population analytics systems can considerably improve payer strategies and promote holistic caregiving by addressing the specific needs of relevant populations.

 

Progress Analytics

Among the various healthcare payer data analytics solutions, progress tracking is critical toward the smooth execution of the organization’s payer-related plans and activities. Progress analytics backed by data-related research offers holistic and valuable feedback that helps the organization track current tools, services, and approaches.

Progress analytics systems provide formative modeling methods, advanced data analysis, and reliable transportation planning modeling and traffic analysis. Through progress analytics systems, payers can review their plan design for claims regularly and make changes based on the findings to derive transformative results.

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Use Cases

What We Offer?

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Quality Analytics

At OSP Labs, we deploy predictive analysis and care quality intervention strategies to put together data and information to offer insights that can render substantial quality improvement. This strategy toward healthcare payer data analytics software identifies critical factors and measures from the data to provide feedback towards quality improvement towards claims data and clinical components.

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Risk Adjustment

We undertake the implementation of solutions that come with the capability to monitor structured and unstructured forms of data to analyse historical and current healthcare information to identify and predict areas that require intervention. Through data mining embedding in our healthcare payer data analytics software costs are substantially reduced and outcomes are improved substantially with actuarial risk adjustment and fraud detection and vulnerability tracking.

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Evolving and Holistic Compliance Alignment

As regulatory processes and compliance procedures evolve, our healthcare payer analytics software is geared to automatically adapt and comply with the changing regulatory requirement. We further provide consulting support to orient the entire payer organization with the changing structures and help your organization to adjust to the modifications and reap the benefits of the same.

Keeping Your Trust, Always

We follow every government's regulatory mandate and create solutions that adhere to strict protocols.

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