Healthcare Analytics Case Studies

Case Study: Bridging analytics and CDI for optimizing risk adjustment suspect condition capture

Executive Summary - Most providers participating in risk adjusted contracts view risk adjustment optimization as a function of revenue enhancement. Most providers participating in risk adjusted contracts view risk adjustment optimization as a function of revenue enhancement. However, risk adjustment optimization is now an autonomous competency function critical for overall provider success in the risk adjustment sector

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Case Study: Eastern washington hospital leveraging india resources amid fiscal pressures

Executive Summary - The maturity of an organization determines its scalability and operational agility to adjust to shifting reimbursement structures, specifically alternative payment models. At a 300-bed hospital in Eastern Washington, patient volumes for commercial and federal payers have consistently decreased due to the competitive landscape within the region, a talent deficiency, payer exclusivity clauses, and legacy staff using aged methodologies in a 'new age' environment.

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AR Denials & Liquidity

Challenge: A major hospitalf realized three consecutive quarters of declining net collections.

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DNFB Analysis

Challenge: DNFB over $9,000,000 for three consecutive months equating to 12 days of encounters.

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ICD- Impact Analysis

Challenge: Client had exponential decrease in charges per encounter.

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Cost & Utilization Analytics

Challenge: Cost and Utilizations weren't viewed at Physician, Hospital, Enterprise, and Health Plan.

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