Overview

Federal mandates and stiff competition are accelerating the move towards value-based care. In fact, more than one-third of payments are now based on value* according to a recent report from Healthcare Payment Learning and Action Network. With the fee-for-service model on the wane, healthcare spend is under the scanner, making it imperative to adopt a data-driven and patient-centric approach. This requires enterprises to organize, unify, analyze, and visualize data for better business decisions and to drive business transformation.

Virtusa, in partnership with IBM Watson Health, helps address the changing market conditions with Healthcare AnalyticsToAction – a solution that enables companies to use data and analytics in providing value-based care. The solution leverages IBM® Flexible Analytics Platform and IBM® MarketScan Research Databases for data-driven insights based on real-life healthcare patterns. Healthcare companies can use the solution to better understand the demographics of their members, close gaps in care, and align with quality measures and initiatives.

 

Healthcare AnalyticsToAction graphic

Healthcare AnalyticsToAction Solution for Payers

Healthcare AnalyticsToAction applies business intelligence to augment performance, manage patient health, and address compliance.

Healthcare companies can leverage value-driven insights on

Provider Performance

 

Evaluate physician performance, drive behavioral change, and compare and optimize the performance of network providers.

Provider Performance

  • Peer group comparison: Compare providers based on parameters such as quality of care and efficiency
  • Cost evaluation: Assess performance in cost to care by applying industry accepted risk adjustment methodology
  • Quality evaluation: Analyze compliance to care standards based on performance in clinical metrics
  • Composite scoring: Compare provider performance with in-depth analysis and composite scoring in clinical effectiveness
  • Physician scorecard: Build a comprehensive scorecard on physicians’ performance to give insights on effectiveness and efficiency of care
  • Patient action list: Provide holistic feedback to providers, identify gaps in patient care and classifying patients for intervention

Quality evaluation for providers

Healthcare AnalyticsToAction evaluates the quality of care and identifies the highest-performing providers in comparison to their peers. It classifies providers into categories , provides data to drive decisions around re-credentialing and performance reviews, and provides a ranking system on clinical effectiveness for major specialties.

 

Provider Performance

Care Management

 

Classify members, identify actionable interventions, and evaluate the impact of care management programs.

Care Management

  • Classify members: Segment member data into categories for appropriate intervention
  • Identify profitable interventions: Identify members or population that will benefit the most from the engagement
  • Evaluate programs: Assess clinical, behavioral, and financial impact of care management programs
  • Comprehensive dashboard for patient care: Get a holistic view of patient journey across claims, utilization, and quality metrics etc.
  • Assess severity: Predict risk for the targeted population and classify patient conditions into disease categories

Provider comparison

Healthcare AnalyticsToAction compares the clinical effectiveness of providers with peers and industry benchmarks. It measures providers’ progress, identifies their focus areas, and helps understand patterns.

Care Management

Account Management

 

Deliver reliable, precise, and timely information to employers with comprehensive analytics and insights.

Account Management

  • Highlight key trends: Incorporate rules to highlight the key areas of focus for each account
  • Demonstrate plan value: Generate insights that reflect your plan’s impact on cost, utilization, and quality
  • Address unique reporting needs: Utilize advanced analytics and visualizations to provide a comprehensive view of the business unit
  • Compare with peers: Provide employers with context to compare costs and analyze real-life healthcare patterns

Provider distribution

Healthcare AnalyticsToAction analyzes provider performance based on geography and reflects how cost and quality measures vary by patient age, gender, geographic location, and medical condition.

Account Management

Solution Benefits

Virtusa is committed to address some of the most complex healthcare challenges using data and analytics, AI, and automation. Powered by a design-thinking approach, our solution is designed to deliver interventions aimed at improving health outcomes.

Offer Flexibility and Scalability

to meet changing business priorities

Decreases Complexity

as analytics integrates with your data warehouse and business intelligence tools

Accelerate Time to Insight

by facilitating end-to-end integration of analytics into efficient workflows

Increased Member Satisfaction

is driven by the accessibility of information

Optimizes Resources

and decrease the need to deploy internal resources through analytics

Predict Risk and help Reduce Costs

by incorporating data intelligence into day-to-day operations

Virtusa + IBM Watson Health

Virtusa has partnered with IBM Watson Health to develop Healthcare AnalyticsToAction and to lead the digital transformation of healthcare towards value-based care using data and analytics. Healthcare AnalyticsToAction is a holistic solution that leverages the Flexible Analytics Platform and MarketScan Research Databases to derive action-driven insights that allow you to augment performance, manage patient health, and address compliance.

The Flexible Analytics Platform is a robust analytic solution that simplifies the deployment and operations of multiple analytic methods. The Flexible Analytics Platform technology and analytics prowess provides implementation and business intelligence support services as needed. It integrates with your existing data warehouse and business intelligence tools via a Software as a Service (SaaS) or on-premise model.

The MarketScan Research Databases is one of the largest and longest-running collection of privately and publicly insured patient data in the United States. It furnishes a sophisticated robust dataset that allows researchers to follow the continuum of healthcare. ​The MarketScan Research Databases harness the power of data by exploring datasets and extracting meaningful insights and benchmarks financial and clinical performance by leveraging comparative data.

“The IBM Watson Health-Virtusa partnership expands the reach of the IBM Watson Health suite of solutions, leading providers and payers through value-based care transformations by leveraging data and analytics that are powered by design thinking and automation. Together, we are empowering innovation and healthcare transformation by providing tools to aid in interpreting data, managing population health, engaging patients, and optimizing business outcomes.”

Barbara Graovac, Senior Vice President and General Manager, IBM Watson Health.

 

IBM Watson Health aspires to improve lives and deliver innovation to address the world’s health challenges through data and contextual insights. Virtusa is an IBM partner across all their information management products, analytics products, and cognitive services.

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