Complex healthcare programs like Medicaid and Medicare, that are often outsourced to Managed Care Organizations, require detailed claims level analysis to ensure that the insurance companies are compliant with their service obligations.

Datalysys can assist Govt Agencies, Audit & Actuarial firms in this sector with data services like: aggregation, transformation and modeling of claims data across systems and help develop analytics that can instrumental in:

• Measure MCO Performance
• Monitor Member Enrollment
• Ensure Data Accuracy
• Monitor Network Adequacy
• Develop Risk Level Cohorts

A proper claims modeling strategy is a basic requirement in quickly identifying cost of care and utilization trends. Datalysys’ cloud based analytical platforms seamlessly integrates data from various sources to develop data models that:

• Drive decisions based on connecting the dots between utilization and cost of care.
• Provide real time information to key stakeholders on cost and utilization outliers that materially deviate from the baseline.
• Goes beyond “what” is driving a data outlier to the “why” a data point is an outlier.

Get an in-depth understanding of the healthcare industry to inform policy decisions. Our data solutions can provide real-time insights with real-world context so that your agency can identify new opportunities and evaluate service coverage.

Our Population Health Analytics, you can help:

• Understand Health Outcomes
• Identify Effective Interventions
• Track Costs & Compare Service Availability
• Predict the Financial Impact of New Initiatives
• Measure the Financial Benefits of Existing Programs