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MedMetrics®,LLC
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The Industry Problem Managed Care programs in Workers' Compensation have been in place for over twenty years, yet medical costs have relentlessly increased. According to the NCCI, medical costs now amount to 60% of claim costs and the portion is increasing. Still, we continue to do business as usual. Similarly, the costs for providing or purchasing managed care services continue to climb, without proof of value. Medical Case Management, Utilization Review, Peer Review, Bill Review programs, and medical provider networks all cost more to purchase or maintain, yet their contributed value is unknown. The MedMetrics Solution-Linking Business Intelligence to Operations Reinventing Managed Care programs is not an option. Huge sunk costs and thriving businesses resist major change. However, a better answer is to refine, invigorate and empower existing medical management programs by operationalizing data-inspired business intelligence. MedMetrics offers insurers, self-insured/administered employers, third party administrators, and managed care organizations the means to gain and operationalize their Business Intelligence easily and affordably. MedMetrics collects, validates, integrates and analyses an organization's data, then uniquely converts the information results to electronic tools that optimize efficiency, effectiveness and profitability. Business Intelligence is a concept widely implemented in other industries where an organization intentionally gathers, organizes, and analyses its data. With MedMetrics, the resulting information is reformatted into electronic tools that are easily accessed for decision support and informed action. Advances in technology and the ways we can access and share information have made such knowledge management feasible and affordable, especially for Workers Compensation medical management. MedMetrics uniquely creates a medical knowledge management platform, tooled to immediately and positively impact claim outcomes, managed care operations and organizational profitability. MedMetrics medical knowledge management tools include Predictive Intelligence Profiling, Provider Performance Analysis, and "Ask-the-Data" Query Library.
Drill-down features MedMetrics amplifies the results of medical data analysis with drill-down features that leap-frog users through further study. Outlier claims for a set of conditions are listed so users can investigate further. Claim summaries clarify provider involvement, the treatment process and other variables. Drill-downs are short-cuts to deeper analysis, better understanding and decision support. Affiliations feature MedMetrics customers' clients and accounts are called Affiliates. They are segmented hierarchically so that one client or account's performance can be carved out and compared to the book of business. Moreover, the hierarchy is multi-layered, providing configurations appropriate to each account. Affiliates in the data can also be authorized via password to view their unique information results. Consultation MedMetrics offers subject matter and IT consulting services. As subject matter experts, we assist our clients in creating their unique and comprehensive Predictive Intelligence Profiles and action benchmarks. We also design analyses and studies that address and interpret specific information needs. Moreover, we assist in applying business knowledge gained through analytics to operations to achieve efficiency, support management decisions and determine how to sustain or satisfy client accounts' and management's demands for measured results. MedMetrics experts will also consult with IT personnel regarding data transfer and security from current, legacy or vendor systems to MedMetrics. We validate, integrate, normalize and map the data, freeing MedMetrics customers' IT personnel of those tasks. MedMetrics ROI Calculator MedMetrics brings its users an array of analytics application tools that result in administrative savings. ROI Calculator, found on the MedMetrics HOME page and accessible to anyone, is another tool provided to assist in measuring value-the value of using MedMetrics! Use of the MedMetrics ROI Calculator tool is free! Fill in the blanks in the ROI Calculator estimating your monetary return gained from using MedMetrics. Simply contact MedMetrics to obtain estimated annual license fee based on claim volume or organizational size to complete the calculation. The ROI calculator will determine your return on investment. Custom queries, studies, and data services MedMetrics will develop custom queries and studies upon request. MedMetrics designs custom analyses to elicit new business knowledge or present results differently. MedMetrics will develop electronic claim summaries, audits of claims, programs, and contract compliance, for example. MedMetrics WC medical data warehouse MedMetrics imports, validates, integrates and maps your medical billing data and select claims level data on a continuous basis. Initially, we import and integrate current and historical data. Subsequently, we invite data from additional, related systems such as vendor systems, legacy systems or other sources in order to gather the most comprehensive and appropriate data set and insights needed. The data are stored separately for each MedMetrics customer in their confidential and secure sector of our Workers Compensation medical data warehouse. Confidentiality and security are imperative for all data. For instance, MedMetrics does not transfer claimant personally-identifiable data, thereby insuring strict confidentiality. MedMetrics makes transferring data easy and secure. We will accept data in nearly any form and format, accompanied by a data dictionary, usually transferred via secure FTP. To keep data current and results most powerful and actionable for medical management business units, MedMetrics suggests data be refreshed frequently, optimally, on a daily basis. |
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