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.

MEDICARE SPENDING RAPIDLY RISING

医保支出预计在未来八年内翻一番，每年超过1.5万亿美元。¹Due to this rise in spend, healthcare providers must find areas to improve the quality of care while also reducing costs.

DISPARATE DATA CHALLENGES SHARED SAVINGS EFFORTS

Acuitas保健公司面临的挑战是，要找出降低成本同时改善质量结果的机会。数据位于多个不同的数据源，需要繁琐的手工流程来获取感兴趣的数据。

Incentives and rewards for payers and providers are often at odds. At times, a mechanism to pursue the same goals was missing.

PROVIDER ANALYTICS AND OPERATIONS SUPPORT FOR SHARED SAVINGS

Acuitas Health uses the Health Catalyst^®Data Operating System (DOS™) platform and a robust suite of analytics applications, including hospital activity analytics, a pre-visit planning suite, HCC opportunity analytics, and machine learning models for fall risk and readmission risk, to enable payers and providers to connect, communicate, share insights, and develop common ground through neutral solutions.

DOS helps Acuitas Health bridge traditional analytics and technical solutions with clinical and business operations. Using Acuitas Health’s advanced analytics, payers and providers can identify opportunities to decrease costs for both parties, and increase outcomes that yield benefits in several areas, including quality improvement, coding optimization, and risk adjustment.

Acuitas Health使用DOS和闭环分析集成来自十多个不同系统的数据，改善了合作临床医生的数据访问。临床医生在患者就诊前会收到针对患者的详细信息，以支持临床医生做出数据驱动的医疗决策，并增加最佳实践的采用。闭环预警通过访前规划解决方案提供给临床医生，让临床医生发现健康维护的机会，提高质量和HCC编码。

Acuitas Health uses the HCC opportunity analytics to identify opportunities to increase coding specificity where clinically appropriate. The organization can identify providers who use a generic code for a condition where specific codes may be more accurate, allowing the organization to engage with providers to improve the specificity and accuracy of clinical documentation. The analytics also compares providers to others in the system, and the system average, identifying those providers who may benefit from HCC coding education.

Admission, discharge, and transfer data from the health information exchange (HIE) is leveraged by Acuitas Health to ensure providers are aware of hospital activity for their patients. The organization utilizes machine learning to identify readmission risk, and natural language processing (NLP) to pull text out of alerts and discharge summaries, categorizing the data and defining a framework for intervening to prevent future admissions.

RESULTS

Acuitas Health的供应商分析和运营方法帮助其客户实现了大量共享节约，包括:

• Nearly $2M in shared savings in just one year.
• Over a $20 PMPM reduction in cost for inpatient hospital services for a significant portion of a provider’s business, driven, in part, by lower utilization.
• 肝癌评分增加6%，反映了临床记录的特异性和准确性的提高，以及多种疾病管理的改善。
• 在实施后的第一周内，完成访前计划所需的时间减少了近70%。

Following the stay-at-home orders related to COVID-19, many patients chose not to complete previously scheduled in-person medical care. Acuitas Health observed a dramatic decline in visits overall, a rapid increase in virtual care, and after several months, a significant rebound in visits in general.

就诊次数减少意味着就诊前提醒提供商的次数减少。随着出诊开始恢复，出诊前警报的使用也开始恢复，速度比COVID-19之前更快。Acuitas Health发现，在两个月内，使用访前规划解决方案的人数增加了68%。访前规划解决方案对结果有积极的影响。2022卡塔尔世界杯赛程表时间Acuitas Health观察到，在访前规划解决方案使用率较高的地方，编码机会关闭率较高。

“关于医疗保健中的分析和技术的讨论，往往缺乏以深思熟虑的方式与合作伙伴联系，提供见解的软方面。我指的不是仪表板的“类型”。我的意思是在能力的基础上建立理性的关系和信任，以及对主题的尊重作为分析的基础。在Acuitas Health，我们融合了临床、技术、商业和统计方面的学科和专业知识，提供最佳的翻译服务。”

– Keegan Bailey, MS, Strategy and Technology Leader

WHAT’S NEXT

Acuitas Health will continue to expand its use of advanced analytics, helping providers and payers find common ground to improve healthcare quality and reduce costs.

REFERENCES

1. Chiedi, J. M. (2019). ACOs’ Strategies for Transitioning to Value-Based Care: Lessons from the Medicare Shared Savings Program.美国卫生与公众服务部监察长办公室Retrieved fromhttps://oig.hhs.gov/oei/reports/oei-02-15-00451.asp