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Despite over twenty years of managed care programs and network discounts, medical costs in Workers Compensation continue to rise, some at double digit rates. The NCCI says medical costs now amount to nearly 60% of claim costs! At the same time, the administrative costs of providing medical management services continue to rise, significantly adding to the cost structure and limiting efficiency and profitability. If you are not managing by leveraging your data, you are probably missing your best opportunities for reducing costs. MedMetrics® makes it easy for you to integrate your data from your disparate software systems and vendors to find the solutions in your data, to alert you to case events early, to increase your administrative efficiency, and to analyze your cost drivers. The Proof of Value is increased operational efficiency and profitability along with improved claim outcomes and reduced claim costs. Internet-based-easy web site access to live analysis MedMetrics® users access analyses of their data from the MedMetrics® Defined Query Library in their secure sector of the MedMetrics® web site. Web site access is password-protected and authorizations are managed by the user. Executing live queries is easy and intuitive, making training unnecessary. Applied Analytics MedMetrics® emphasizes the power of applying the medical analytics to the operational process, rather than simply displaying graphics. Examples of applied analytics are the MedMetrics® Risk Alert system, provider ranking and zip region best practice providers look-up, outlier drill-downs and our affiliations feature. These functions allow users to transfer the business intelligence resulting from analytics directly into operations. Risk Alerts Besides analyzing the data, MedMetrics® uniquely provides a Risk Alert system whereby data are monitored continuously. When data elements or combinations of data elements that have been identified as potentially high risk or high cost appear in the data, MedMetrics® immediately notifies appropriate persons. This powerful feature is also known as Predictive Actionability! Provider Activity Analysis MedMetrics® provides provider activity analysis comparing process analysis and costs among peers who have treated similar conditions. MedMetrics® also ranks providers based on composite performance. Additionally, users can look up Best Practice providers for treating specific injuries in a zip region. Drill-down feature Another MedMetrics® applied analytics feature is drill-down. MedMetrics® guides users through the next steps when an outlier is apparent in a graphic. You can drill down to see a list of claims causing the outlier status. In the case of provider analysis, you drill down to individual claim summaries so you can determine the extent of involvement for that provider. Claim summaries are a powerful means of gaining efficiency. Affiliations feature MedMetrics® arranges your data so that you can compare one account or customer performance with the balance of your book of business. You carve out cost drivers or best performance for individual accounts. You can also elect to grant individual customers password access to that information. Please review additional MedMetrics® information and services listed below. MedMetrics® ROI Calculator MedMetrics® Defined Query Library Your Proprietary Query Library Custom Studies Focused Value Studies Consultation MedMetrics® WC medical data warehouse MedMetrics® Defined Query Library The MedMetrics® Defined Query Library is your medical information dashboard where clearly defined, easy-to-understand decision information is brought to one screen for you. A library menu of pre-defined queries you can execute from live data is available to you with just a click. Then choose how you want the information organized and select a date range, state, provider or provider type, employer industry, injury type and/or diagnosis. Defined Queries mean MedMetrics® has designed the queries for you. You execute the queries from live data directly from your sector on our website. An example of a typical Query is comparing cases in terms of frequency, duration and cost of medical services by injury type or diagnosis, with and without PT or Chiropractic. Another example is to look up a provider’s ranking benchmarked against best practice in the data. Back to list Your Proprietary Query Library MedMetrics® will optionally edit and enhance your Query Library with your additional, proprietary analyses. In fact, we will create your exclusive Query Library designed to offer information and decision support you specifically want. Now that your data are normalized in our warehouse, elaboration and drill-down is efficient, accurate and cost-effective. As an example, you may want MedMetrics® to perform in-depth medical cost driver analysis for you. Our team of experts will work with you to uncover your cost drivers hidden in your data, and often the solutions, as well. Another opportunity using MedMetrics® is electronically monitoring contract compliance for you. Consider electronically monitoring your contracts, vendors, and networks to assure proactively you are getting the results you expect. When indicators trend toward non-compliance, MedMetrics® alerts you. Back to list Custom Studies MedMetrics® will conduct Custom Studies at your request. MedMetrics® team of experts will design custom analysis to elicit the intelligence you want. We will articulate your goals and define the scope, time-line and budget for the study for your approval. Again, because your data are normalized in our warehouse, such projects are efficient, accurate and cost-effective. MedMetrics® will conduct electronic audits of your programs, activities or operations. We scrutinize and analyze your data to gain new business intelligence for you. Back to list Focused Value Studies MedMetrics® will, from time to time, offer Focused Studies whereby a “Call for Participants” is extended for a specific study. Focused Studies may be confined to a specific geographic area or to one injury type, provider type or service type. MedMetrics® customers and others may be invited to participate as Focused Study consortium members. Back to list Consultation MedMetrics® is available for consulting, assisting you to design analyses and studies that specifically address and interpret your information goals. We will also assist you in applying your business knowledge gained to achieve efficiency and leverage the information to retain current accounts or gain new customers. Of course, efficiency and cost savings is always a paramount goal. MedMetrics® experts will also consult with you and your IT personnel regarding data integration and transfer between systems or to MedMetrics®. We will help map your data, cleanse your data and provide data quality evaluation and related operational problem-solving. Back to list MedMetrics® WC medical data warehouse MedMetrics® imports and integrates your medical billing data, along with your claims level data to your confidential and secure sector of our Workers Compensation medical data warehouse. We will also import and integrate data from other systems, legacy systems and other sources such as Excel spreadsheets in order to gather the appropriate data to gain the information you want. Moreover, MedMetrics® can separate your key accounts data within your sector so you can execute separate queries on their behalf. We will even private-label the results for you to share with your accounts. MedMetrics® makes importing data to our warehouse easy. We will accept your data in nearly any format, arranged in any way, as long as you provide a data dictionary describing the layout. To keep data current and results the most useful, MedMetrics® suggests data be refreshed frequently and regularly with similar transfers. Back to list |
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