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Payers

Make knowledgeable, evidence-based decisions that positively impact your network’s performance.

To do this successfully in today’s value-based world, claims and billing data need to be integrated and analyzed with clinical data. That’s where we come in.

 

Aggregate

Data aggregation is essential to collaborate effectively with providers, key stakeholders, and consumers for better outcomes and optimal return on investment. Regardless of data type, format, or location, SpectraMedix will access the wealth of data available to you and help you pull the information you need from it.

Analyze

Payers need data-driven analytics to manage member attribution, report quality measures, analyze providers on a risk adjusted basis, and for cohort management. We provide payers with insights across adjudicated claims, billing, and clinical data and enable them to perform retrospective and predictive analysis to determine risk within their insured populations.

 

 

Transform

The journey to Value-Based Payments relies on data and analytics. Proactive health plans are using the wealth of information available to them to implement innovative strategies to manage member risk, streamline operations, and manage the health of their enrolled populations. The SpectraMedix Platform enables them to do this.

BENEFITS

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Data Driven Care Gap Identification

Flag plan members who fall short of key metric benchmarks so you’re able to create follow-up strategies, like chase lists, to close gaps. Our analytics provide the insights needed.

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Provider Performance Scorecards

Scorecards keep plan administrators in the know with insight into utilization, cost, patient satisfaction. At a glance, see the providers who meet or exceed goals, and those who do not.

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Population Health for Patient Engagement

We use predictive risk models and analytics to assess patients’ adherence to prescription usage and other directives. Plus, we integrate Social Determinants of Health data to understand how to actively engage patients in their own health and well-being. You’ll save time and money, improving clinician and patient satisfaction.

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Medicare Advantage Management

STAR ratings drive reimbursements and premiums. SpectraMedix’s helps identify diagnosis discrepancies that contribute to plan losses and early intervention opportunities.

The SpectraMedix Platform for DSRIP

The solution of choice for
20% of New York State Medicaid Performing Provider Systems (PPSs).

Read more about our client, NY’s top performing PPS

  • The amount of data we receive from our participating providers is staggering.

    L.A. Care Health Plan

    We chose SpectraMedix because they can aggregate and analyze the data for us, then present the meaningful insights we need to maximize the impact of our program


    Read the case study

SEE HOW SPECTRAMEDIX CAN WORK FOR YOU!

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