Over a Hundred Reporting Clients throughout the country. 95%+ Client Retention

Transcription

1 The Leader in Web-based Reporting for Managed Care Organizations Diverse base of Managed Care clients (IPAs, PHOs, HMOs & MSOs) Providing Managed Care Analytics and Business Intelligence for over 10 years Over a Hundred Reporting Clients throughout the country 95%+ Client Retention Since 1995 ManagedCare.com has been providing reporting, advisory and operations consulting to a wide range of payer and provider organizations. The company offers web-based (ASP) managed care reporting services and remains exclusively focused on this model. We offer a complete, integrated suite of tools that includes thousands of report views, graphics and related drill-downs, as well as a variety of complementary applications addressing such areas as: Web-based Physician Profiling our dashboards are available directly to the provider and capture all aspects of utilization and quality performance. They offer member exception reporting for P4P and other measures, and link to EMR-like member summaries that profile members clinical and claims histories. Disease Management through our Program Management Tool, a full-spectrum registry application that dramatically updates disease associations, performs risk stratification, tracks care manager activities, produces clinical exception lists and more. OLAP Analytics using our Business Intelligence Tool. This easy-to-use interface enables any user to obtain instantaneous analysis of cost and utilization trends around key business units, diseases, providers, etc. Employer Reporting our Employer Dashboards and related views export key metrics to the plans key customers in a format that is both succinct and comprehensive. Comparative Benchmarking all our clients receive integrated benchmark reporting in which their own cost and utilization patterns are compared to national and regional averages from across our national database. These represent only a fraction of our range of management information services. In addition to these services, we also provide all our clients with standardized reporting on all Healthcare Effectiveness Data and Information Set (HEDIS) measures. This monthly reporting is distinct from our annual HEDIS submission services. The latter is a separate service line in which HMOs utilize ManagedCare.com s certified software to complete their annual submission and/or accreditation activities with respect to NCQA or other regulatory agencies.

2 A secure application services provider eliminates the need to build and maintain custom software for your medical web-based data analytics reporting requirements Client Data File Input ManagedCare.Com Secure Medical Data Analytics & Reporting Applications Institutional Reporting & Filing CMS, NCQA etc. Client Data File Input Client offices THE MANAGEDCARE ASP REPORTING SYSTEM An All-Inclusive Suite of Web-based Reporting Applications the Country throughout

3 MANAGEDCARE.COM Monthly Processing Cycle Understanding our monthly processing cycle is useful for clients, as it allows them to better anticipate the timing of key activities, and schedule any special requests that may be affected by resource availability during the month. Data Extracts Received Data In-Load (Steps A-C ) Main Compile Completed New Reports Loaded Other Activities Production 1st 15th 25th 31st Step Timing (Dates) Description 1 5th-10th Raw client extracts are received, via CD or FTP transfer, in native formats such as text or database files 2* 5th-20th In-loading (Step 1) Copies of these native files are in-loaded onto ManagedCare.com servers for further manipulation 3 5th-20th In-loading (Step B) Using customized conversion programs developed for each client, the raw data is translated into structured SQL databases containing fields essential to the subsequent compile. 4 5th-20th In-loading (Step C) Individual client databases are in-loaded into the main database for processing 5 21st-24th The Compile All clients data is processed simultaneously as part of the main monthly compile. This procedure can take anywhere from hours depending on a number of factors. 6 24th-25th Posting SQL-based output tables are up-loaded into ASP files which populate the various report views on the Web. The new month s reports appears on the menu bar of each client. * This timeline is for initial setup, subsequent client data extracts are typically received anywhere between the 1st and the 10th of the month and require 5 to 7 days to become available online

4 APPLYING OUR LIBRARY OF STANDARD REPORTS - Dashboards - Benchmarking - Program Management - Business Intelligence - HEDIS - RAPS The initial stage our client relationship includes extensive joint analysis of the client's reports. Together we explore the full gamut of potential opportunities, and select those that are most promising through a combination of: Benchmarking - using our comparative data repository to highlight unusual patterns of utilization across all diseases, specialties, modalities, etc. Physician Profiling - to identify providers who are primary contributors to these variances, or whose practices distinguish them from their peers Trending - capturing areas of rapidly increasing cost/utilization Drill-down Analysis - enabled by the extensive drill-down and report navigation features embedded in our Spectrum reporting suite At the conclusion of our analysis, the client has established a short list of target initiatives; examples of these might include: Reducing the length of stay for abdominal hysterectomies Stemming network leakage of physical therapy referrals Adopting a disease management protocol for coronary artery disease, or Improving use of generics in the treatment of high blood pressure

5 Your HealthCare Organization Logo Mouse-over activates member-level detail Branded to preserve continuity of user experience Additional mouse-over added to access aggregated care gap list (next page) PROVIDER PORTAL PCP Dashboard KPIs...

6 Your HealthCare Organization Logo Member in 3 different HEDIS denominators Care gap reporting can include HEDIS, P4P, medication adherence, or other Provider offices can export data to Excel for mail merges Addresses, phone numbers typically included in output PROVIDER PORTAL Care Gap Lists...

7 Your HealthCare Organization Logo Provider dashboards can be used to profile utilization, quality, or other practice characteristics PROVIDER PORTAL PCP Dashboards...

8 Your HealthCare Organization Logo Disease-specific performance comparisons Drill-down to member-level detail (next page) Benchmark averages (all IN Drill-down Medicaid to plans) member-level can included detail in any provider KPI PROVIDER PORTAL PCP Dashboards..

9 Your HealthCare Organization Logo Drill-down to member-level detail (next page) PROVIDER PORTAL Registry Lists...

10 Your HealthCare Organization Logo Member demographic section includes key disease management programs Member demographic section includes key disease management programs Input options for labs and other clinical data, assessment forms, etc. PROVIDER PORTAL Member Detail Reporting...

11 Your HealthCare Organization Logo Disease-specific views for patients in chronic care registries (next page) PROVIDER PORTAL Member Detail Reporting...

12 Your HealthCare Organization Logo Clinical measures are customized to profile specific diseases Mouse-overs lead to claim-level detail of visits, drugs, etc. PROVIDER PORTAL Member Detail Reporting...

13 DISEASE MANAGEMENT Clinical Data Input... Ability to upload scanned images of chart data from provider portal

14 Custom assessment forms can incorporate historical claims, drive risk scoring, and capture data for other reporting DISEASE MANAGEMENT On-line Assessment Forms..

15 DISEASE MANAGEMENT Population-Level Reporting via Dashboards...

16 DISEASE MANAGEMENT Population-Level Reporting via Dashboards...

17 DISEASE MANAGEMENT Population-Level Reporting via Dashboards...

18 Your HealthCare Organization Logo DISEASE MANAGEMENT Patient-Level Management Tools...

19 Our Objectives: Easy of Use Affordable Thorough Unlimited Users Intuitive E-Z to Use 90-day Termination Option New Report Views on Demand 10+ Million Member Warehouse Medical and Rx Claims; Lab Data EZ Identification of Best Practices Constant, Client-Driven Innovation Monthly Imports of Claims Data via CD or FTP New / Custom Application Development 3-4 Week Initial Setup Low Monthly Rate A Single Rate for Our Entire Range of Services Access to Our Entire Network for Medical Management Know-How CHOOSE A TRUE PARTNER FOR YOUR MEDICAL DATA MANAGEMENT & REPORTING