Learn: Payer

Success Story
Analytics and Provider Operations Support Generates Nearly $2M in Shared Savings

Acuitas Health was challenged to identify opportunities for shared savings, reducing cost while also improving quality outcomes. Using Acuitas Health’s advanced analytics, providers and payers can now connect, communicate, and share insights that enable the organizations to identify opportunities to decrease costs for all partners, and increase outcomes that yield benefits in several areas, including quality improvement, claims optimization, and risk adjustment.

Insights
Resetting Payer-Provider Arrangements for COVID-19 and the Evolving Improvement Journey

With the pandemic driving lower provider volumes and straining hospital resources, the industry has a renewed urgency for policies that drive better outcomes while lowering cost and improving revenue. Moving forward, healthcare must reset its payer-provider performance standards to the post COVID-19 environment.

Renewed approaches to the following models will consider the impact of remote care, how to reimburse telehealth services, and the need for consistent payments to providers

Success Story
Analytics Improves Population Health and Drives Efficiencies

Agilon health, an organization that partners with physician organizations in full risk contracts, needed a way to help its physician partners and care management staff quickly identify patients in danger of deteriorating health status and increased cost. However, taking a deeper look at the health status and costs associated with these patients was complicated by the slow manual review of data. By developing an analytics application, agilon health was able to turn its data into actionable insights, automate many manual processes, and ultimately provide targeted improvement interventions aimed at better care delivery.