We know health plans make considerable investments in their clinical care programs. However, studies confirm most plans only measure the effectiveness of a handful of these programs annually. And when they do, measurement is often done manually with inconsistent methodologies and governance. The result is reduced program yield and inefficient use of scarce and expensive analytics resources. Let NextHealth do it faster, and better.
We ingest all your claims, enrollment, Rx and other types of data as well as third party SDOH and similar data into a single master member data file (MMD). Then we update your MMD monthly. We enable configuration of all your clinical programs on our platform, including populations, Key Performance Indicators (KPIs) and similar measures.
Your plan can measure and optimize all of your clinical programs continuously and automatically instead of just measuring some periodically and manually. This improves program yield, along with the ability to shift resources away from analysis to action.
When we partner with health plans, they see profoundly positive results on a wide range of issues. After partnering with a regional health plan, we analyzed 50 clinical programs to identify more than $70 million in realizable cost savings. NextHealth helped this plan go from insight to action in six months rather than years.