1. Healthx Analytics: Turning Data Into Actionable Insights
Presented by: Lawrence Schimmel, MD – QualMetrix Founder and Chief Medical Officer
Richard Krol – QualMetrix SVP, Business Development
Doug Wilcox – Healthx Director of Marketing

2. The Need for Actionable Insights
Institute for Health Improvement’s
Triple Aim

3. The Need for Actionable Insights
Better care
Improve the patient experience of care
Lower Costs
Reduce the costs of per capita healthcare
Better Health
Improve population health by addressing determinants of care

4. Healthx Analytics Pre-integrated to Healthx Platform
Easy to learn, easy to use tools to identify opportunities for
Improved care delivery
Efficiencies in resource utilization
Cost reduction related to care
Driving behavioral changes among members and providers
1.20%
$985,082

5. Healthx Analytics
Helps payers and administrators make more informed and strategic decisions
Holistic, in-depth reporting and visualizations
Cost drivers
At-risk patients
Populations
Providers

6. Healthx Analytics
Analytics and visualizations that guide data driven decisions for clinicians and administrators.
Cost & Utilization
Population Health
Provider Performance
Prevention
Quality
Member Metrics

7. What the Analytics Provide
Features
Ability to drill through from high level metrics to actionable lists of providers and members driving performance on key indicators, often on a single screen
Explore cost drivers at different levels of granularity across both member and provider characteristics to understand the clinical and network drivers of costs
Industry leading, internationally utilized risk adjustment methods to remove variations
Dashboards to track all services across the care continuum.
Easy visualization of KPIs and cost measures with trending.
Identify clinical and physician drivers of cost to formulate strategic decisions around utilization management and population health
Cost savings opportunities to focus efforts on maximizing ROI

8. Improved Health Plan Tools
Features
Insights into avoidable cost, such as readmissions, ER Super Users, avoidable ER.
Gaps in care reports that enable care managers to affect member costs.
Reports to highlight high cost care and complications.
Member risk/cost analysis with disease burden. Drill into comorbidities, claims detail, pharmacy profiles.
Trended medical and pharmacy KPIs.
Cost/Utilization by various criteria, e.g. groups, geography, employer group, contract, LOBs.
Network leakage reports and views.
Provider utilization, cost and quality reporting, with peer comparisons (risk adjusted).
More real time, intuitive drill down on data.
Influence behaviors of providers and members.
Visualize data and choose which data points to drill through on to gain more insight. Drill- down capabilities to quickly find plan level statistics to physician or patient level detail.
Need for IT and analytic resources for follow- up queries/reports is minimized.
Pre-integrated to Healthx platform. Fast implementation with small impact on internal IT resources. Quickly set-up robust business intelligence solution with a few extracts.

9. Harnessing the Power of Data
Predictive Modeling
Gaps in Care
Provider Performance
Integrated Analytics Solution
Data shared with integrated
Healthx Analytics Solution
Member Portal
Healthx Platform
Provider Portal
Disparate data integrated with Healthx platform
Data
Claims
Prescription
Member
Provider
Payer Analytic Platform
Actionable
Insights
Customer Data