Solution Analyzes Patient Risk, Care Opportunities and Provider Performance
to Increase Effectiveness of Member Care Management Programs
BIRMINGHAM, Ala., Oct. 29 /PRNewswire/ -- DST Health Solutions today announced the launch of CareAnalyzer(TM), an analytic solution that combines elements of patient risk (The Johns Hopkins University ACG(R) Predictive Models), care opportunities (HEDIS(R)) and provider performance (NCQA's pay for performance program). CareAnalyzer helps health plans meet reporting requirements for the Healthcare Effectiveness Data and Information Set (HEDIS) and effectively identify high-risk members for care management.
CareAnalyzer has been selected by a number of health plans, including CareOregon and FirstCarolinaCare Insurance Company.
"CareAnalyzer combines a variety of data sources to produce actionable information health plans can use to improve the health of their members," said Steve Sabino, president of DST Health Solutions.
By analyzing patient risk data, predictive modeling and HEDIS requirements, CareAnalyzer helps health plans identify high-risk members with chronic conditions such as diabetes, asthma or lower back pain. High-risk members then may be enrolled in care management programs that include preventive health screenings and treatment plans tailored to their condition.
"CareAnalyzer helps us identify members who need care management and intervention, which improves health outcomes and will ultimately save employers premium dollars down the road," said Craig Humphrey, chief operating officer of FirstCarolinaCare. "This tool also allowed us to automate HEDIS reporting, and reduce the staff time needed for this function."
CareAnalyzer incorporates the ACG System, a scientifically proven
software tool for provider profiling, predictive modeling, resource
management, and reimbursement rate adjustment. The ACG System was developed
by The Johns Hopkins University Bloomberg Schoo
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