Analytics

About Health Management Analytics

Preventive PLUS Health Management Analytics group designs, delivers, and operates advanced analytics to help payers and providers meet their most pressing needs, including value-based payment models, medical cost management, network optimization, as well as provider pricing and growth strategy.

Health Management Analytics
Health Management Analytics

Creating Unique Insights

Our multi-disciplinary teams generate unique insights from gathered data and advanced analytics through a combination of:

  • 200+ affiliated professionals with complementary profiles (clinicians, epidemiologists, data scientists, actuaries, software developers), organized in 10 high-value domains
  • 250+ affiliated professionals with deep healthcare expertise and a diverse external clinical advisory network
  • robust infrastructure that allows us to safely manipulate 100+ terabytes of integrated claim, encounter, clinical, consumer, and other data
  • 125+ analytics assets, for the rapid generation of distinctive insights
  • third party data-sets and proprietary technology-enabled tools for data assessment, enhancement, and integration

What Preventive PLUS Analytics Provides

Our group designs, delivers and operates advanced healthcare analytic models to help our payer and provider clients—focusing on 10 specific analytic domains:

Market Insights

A data-driven perspective on the evolving healthcare landscape. Key areas include historical, current and projected health insurance coverage trends, insurer and provider competitive insights (including proprietary exchange network analytics and comparative payer financial performance), deep consumer behavior insights across all commercial and government segments

Episodes of Care

Condition/event specific analytics with a focus on patient journey & including all relevant aspects of the care continuum; includes the design, implementation and evaluation of episode-based payment models as well claims-based analytics which may incorporate data from other sources to inform operational and financial decisions (e.g., network design) or influence consumer behavior

Total Cost of Care

Design, implementation and evaluation of initiatives to reduce medical spend and improve quality through population-based programs and payment models, with focus on both patient centered medical homes (PCMH), and accountable care organizations (ACO)

Network Analytics

Analytics to support insurers in evaluating, designing, and optimizing provider networks using a combination of provider assessment, geo-spatial analytics, and systems optimization

Special Needs Populations

Design and implementation of innovative payment and care delivery models focusing on special needs populations, including the behavioral health population, people with developmental disabilities, and those in need of long term services and supports

Payments, Pharmacy, Risk Revenue

Analytics to detect and prevent improper claims payments; optimize medical and reimbursement policies, effective medical and pharmacy management; and identify missing risk revenues

Provider Performance Improvement

Analytics to help healthcare providers optimize their cost baseline, in particular through procurement, supply chain and vendor management levers

Provider Growth

Analytics and expertise to turbo-charge provider growth and strategy by effectively leveraging client and third party data (ex: hospital financial forecasting, physician practice patterns, day 1 insights, continuity of care capture, etc.)

Healthcare Data Management

Design, development and operation of Big Data capabilities that include infrastructure, technology/platform, data acquisition, data integration (both client and third party data), quality analytics, and data enhancement/enrichment to enable all analytics provided by other domains

Provider Pricing

Analytics to assess health care providers’ pricing and contracting positions, recommend pricing and contracting strategies, and support development of managed care contracting capabilities

We understand that your workforces health matters...