August 01 2017 | 0 Comments | 264 reads Average Rating: 4
Impactful, Indeed: 7 Potential Impacts with Impactability Analysis
Impactability analysis leverages information from a multitude of sources – clinical, claims, financial, pharmaceutical, utilization, cost, supply chain, socioeconomic, demographic, genomic and others – to determine where interventions will deliver the greatest return on investment. In essence, impactability boils down to acquiring the right data and building the appropriate predictive models. The good news is that once the framework for measuring such impactability has been established, it can scale out to address a broad range of issues within the organization.
In fact, the possibilities are vast. Here are just some of the areas where impactability analysis will have, for lack of a better word, a significant impact:
Impact #1: Improving the health of the sickest 20% of Americans who account for 80% of the cost of healthcare in the United States by determining the interventions that can most profoundly close care gaps.
Impact #2: Establishing and addressing provider goals that are achievable through behavioral changes that do not require an extraordinary degree of processing, retooling and/or cumbersome new workflows.
Impact #3: Optimizing reimbursement by quantifying each claim related to the likelihood that it will be paid based on 24 months of prior data.
Impact #4: Improving risk adjustment by identifying areas where closing care caps will improve provider reimbursement by ensuring that patients/members are receiving the level of care the organization is contracted to deliver and that care is being documented properly.
Impact #5: Determining whether a claim is being overpaid by payers or if it needs to be audited through claim, member and provider risk profiles.
Impact #6: Identifying care gaps and behavioral traits that will help life sciences companies avoid reduced payment scenarios by providing the knowledge and incentives to work with providers and payers to implement programs that improve compliance.
Impact #7: Recognizing significant undiagnosed populations and then demonstrating to healthcare professionals the benefits of working to get patients to take their drugs or user their devices as prescribed.
This is just a sampling of the ways that impactability analysis can benefit healthcare organizations. For a more in-depth discussion of impactability analysis, check out our recently published e-book, Behavioral Analytics: Using Actions To Create Insights That Improve Outcomes.