Payer Solutions

• Executive Analytics
• Payer-Provider Transparency

• Medical Management Analytics
• Employer Transparency

• Operations Performance Managment
• Provider Network Management Analytics

MedeAnalytics delivers healthcare performance management solutions that improve
financial, operational and clinical outcomes, with compelling return on investment and rapid time-to-value.

Learn more about:

• Client Success
• MedeAnalytics Platform

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Provider Network Management Analytics enables health plans to proactively monitor provider network performance and align provider incentives with plan goals. This solution reduces administrative overhead by providing continuous, actionable intelligence. Provider relations staff members are empowered to evaluate the efficiency of their networks, implement quality improvement initiatives and ensure appropriate, efficient care. Provider Network Management Analytics leverages disparate data sources and customized business rules to create detailed, comparable and trusted information.

Provider Network Management Analytics is delivered via a web-based analytics platform and supported by experienced healthcare professionals to ensure rapid and sustainable results. With MedeAnalytics, clients have consistently experienced measurable reductions in their medical loss ratio and improvements in provider relations and contracting.

How do health plans use Provider Network Management Analytics?

• Ascertain the root causes of provider practice pattern variation
• Limit out-of-network exposure and identify centers of excellence
• Identify hospital-acquired conditions
• Establish structured metrics guiding provider contracing negotiations and support value-based purchasing
• Detect coding abnormalities
• Identify reimbursement outliers
• Optimize provider tiers based on data-driven analyses and benchmarking
• Visualize issues affecting access to care
• Track outcomes of quality improvement initiatives

The MedeAnalytics Approach to Provider Network Management Analytics

• Suite of clinical, financial and operational solutions for health plan management
• Strategic executive scorecards, personalized dashboards and dynamic analysis
• Healthcare advisory services, data analysis, hospital benchmarking and best practices
• Rapid configuration and ongoing healthcare support services
• Transformation of disparate data silos into a web-based, collaborative intelligence platform
• Software-as-a-Service delivery model requires no hardware, no software and no IT support