Opportunity

Identify the most promising ways to improve health care quality and value

Today, every health care organization is looking to make meaningful improvements. But which initiatives can have the most impact? This comprehensive solution for analyzing care episodes and treatment variations will tell you exactly where to focus your efforts. You can build an ongoing cost and quality dashboard and quickly identify areas to potentially reduce spending and improve care – starting with the “low hanging fruit.”

Product Features

Enables you to conduct effective population health management programs
Offers unrivaled cost and quality transparency across episodes of care to show where spending can be reduced
Uncovers episodes with the greatest cost and quality variation – and the best opportunities for improvement
Generates a “chase list” of patients and providers with the greatest variations
Creates provider profiles, focusing on over- and under-utilization of care
Identifies the best episode candidates for bundled payment programs, to help you break from the fee-for-service past
Builds dashboard reports around specific data points that matter most to you

Health Systems

Identify patients and providers with the greatest variations in costs and quality. Uncover episodes with best opportunity for improvements.

Medicaid

Reveal areas where health care spending can be reduced, and quality of care improved. Identify high utilizers and best providers.

Health Plans

Reveal areas where health care spending can be reduced, and quality of care improved. Identify high utilizers and best providers.

Employers

Reveal areas where health care spending can be reduced, and quality of care improved. Identify best episode candidates for bundled payment programs.

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Altarum is proud to be welcomed as a Preferred Vendor in the Association for Community Affiliated Health Plans in creating a high value, sustainable and equitable health care system through payment and health benefits innovation, behavioral incentives, and consumer engagement.

The Association for Community Affiliated Plans (ACAP) is a national trade association with a mission to strengthen not-for-profit Safety Net Health Plans in their work to improve the health of lower-income and vulnerable populations. Collectively, ACAP plans serve more than seventeen million enrollees, representing nearly half of all individuals enrolled in Medicaid managed care plans.

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After introducing a high deductible health plan, a large regional employer used PROMETHEUS Analytics to discover that some employees with chronic conditions had begun cutting back on ongoing physician care. This could potentially lead to higher rates of potentially avoidable complications (PACs), and therefore higher costs. With this information, the employer can take steps to address health plan design and incentives, and help ensure that their high-risk employees receive all the care services they need to manage their conditions.

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The State of Connecticut’s Medicaid program used PROMETHEUS Analytics to uncover the main reasons for variations in episode costs of care. The program was also able to identify the impact of certain prescription drugs on reductions of potentially avoidable complications (PACs), and understand how health systems compared to one another in managing pregnancies and deliveries. Armed with this data, the Medicaid program can take targeted action to address these critical patient care issues.

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A large New England health system used PROMETHEUS Analytics to measure its cost performance for several episodes of care. The health system found it beat the market average consistently for routine colonoscopies. However, after learning it placed below average for gall bladder surgeries and knee arthroscopies, the organization directed significant resources toward those service lines and populations. After decreasing costs associated with potentially avoidable complications (PACs) by 35%, the health system soon began to outperform market averages for these two procedures as well.