Financial Risk: Cost & Quality

History tells us that successful healthcare organizations have the ability to manage risk.  In today’s environment payers and employers are requiring physicians and health systems to assume financial risk for the services they provide to patients.

To manage financial risk, organizations need a technical infrastructure that easily helps manage the cost and quality of care being provided.

The MedVentive Solution

MedVentive Risk Manager is a clinical integration tool that focuses on helping organizations manage financial risk, any type of financial risk.  As organizations take on risk or begin to think about taking on risk, MedVentive’s advanced, severity-adjusted reporting tools and interactive workflows are proven tools in today’s marketplace. Our ability to proactively manage the key financial and quality indicators for care ensure an organization's success.

Common Areas for Improvement

We have found that the most common areas to target for cost opportunities are outpatient imaging and visits, emergency room usage, inpatient usage, and network leakage.  By understanding your physician utilization patterns, you can improve efficiencies that lower expense without having a negative impact on the quality of care that is delivered.

MedVentive’s Approach

MedVentive partners with you to understand the details of your organization and the risk arrangements in place or under consideration.  MedVentive identifies the analytic tools you need to effectively achieve your key objectives:

• Managing patients with gaps in care
• Identifying patients utilizing the wrong services
• Identifying physicians whose utilization patterns differ from their peers
• Managing high risk patients
• Reviewing drug savings opportunities (brand to generic or brand to brand)

MedVentive Adds Value

• Track performance of individual physicians against financial budgets and clinical goals
• Manage emergency room frequent fliers to quickly identify cost savings
• Provide physician efficiency profiles in easy visual formats, highlighting utilization and identifying opportunities to manage cost more effectively
• Provide cost estimates for organizations without claim data
• Reduce pharmacy costs and increase generic prescriptions
• Model different risk contracting options and adjudicate year-end payment
• Distribute information quickly and efficiently to every physician
• Identify the natural cycle to taking risk, improving performance, and reducing cost

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