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Using Data Analytics for ACO Performance Improvement: Act Upon Opportunities to Improve Population Health



Analyzing integrated claims and clinical data is a powerful tool for elevating performance under value-based payment contracts. Yet the majority of healthcare organizations struggle to produce the reports needed to act upon opportunities to improve population health and reduce costs of care.

To gain the most value from claims analysis, hospitals and physician practices need the tools and skill sets to spot high-level trends and identify top cost drivers and opportunities for improvement. They also must be able to track performance against payer-specific metrics, compare performance to appropriate benchmarks, and create customized reports that drive action for individual service lines, practices, and physicians.

This session will focus on using a data analytics tool to address these issues, and on what is required for implementation. We will use a case study example of how data analytics led to improvements in an underperforming ACO.

Learning Objectives

Participants will learn:

  • The importance of reconciling back to payer reports, utilizing benchmarks, and appropriately risk-adjusting data
  • How to use claims data analytics to:
    • Optimize the participant roster
    • Uncover performance improvement opportunities
    • Select performance improvement initiatives to maximize impact on financial results
    • Develop physician report cards to track process.