Enabling High-Value Provider Performance Through Tailored Healthcare Analytics

HealthCorum delivers granular insights to drive provider network optimization strategies, from regional to nationwide deployments

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Use Cases

Network Development

High-Value Network Development

From new market expansion to remaining competitive in existing service areas, HealthCorum’s scores and insights power provider network optimization initiatives nationwide. View data on all available providers and discover opportunities to reduce wasteful spending while maintaining high-quality care for members.

Surfacing Quality Scores & Price Transparency Data

New regulations now require hospitals and payers to publish price transparency data, empowering patients to make informed decisions when they shop for care. But price alone is not enough – which is why HealthCorum delivers quality indicators alongside the price transparency data in provider search directories, driving value and reducing wasteful spending. HealthCorum also identifies providers who are most experienced in performing a specified procedure or treating a condition, which can further enhance provider search capabilities.

Price Transparency
physician collaboration

Physician Collaboration

Most physicians have tremendous work ethic and treat their patients the best way they know how, so it’s no surprise when performance improvement conversations become abrasive. What’s more, payers and providers often have access to varying degrees of information. HealthCorum delivers a data-driven source of truth that bridges the knowledge gap and helps all parties drive towards appropriate care at a fair price.

Care Navigation

Perhaps the quickest path to impact, risk-bearing organizations have found success in leveraging HealthCorum’s scores to identify the right providers for patient care navigation. Scores are served to care navigators, referral centers, and patients themselves for informed decision making as they navigate to high-scoring providers that are in-network and conveniently located.

Care Navigation
Provider Contracting.

Provider Contracting

With the rise of ACO’s and other risk-bearing physician groups, provider contracting strategy is more important than ever. Give your team the competitive advantage of HealthCorum’s provider reporting and service line benchmarking for a winning compensation strategy based on transparent data.

Referral Pattern Optimization

Referrals are a vital part of tracking patient flow and communication between primary care and specialty providers, yet these relationships are not always apparent. HealthCorum has developed a proprietary solution to identify referral activity based solely on information contained in insurance claims data. Clients use our referral insight to mitigate potentially harmful cascades of wasteful specialty care spending while ensuring that network leakage is kept to a minimum.

Market Intelligence

Market Intelligence

Considering growth into new markets? HealthCorum curates comprehensive market strategy reports, enabling stakeholders to match appropriate risk arrangements based on provider practice patterns and population characteristics in a specific geography. Highlights include utilization and cost of procedures/drugs, chronic condition prevalence, population health factors, and patient flow through the care continuum.

Markets

Health Plans & Insurers

Referrals are a vital part of tracking patient flow and communication between primary care and specialty providers, yet these relationships are not always apparent. HealthCorum has developed a proprietary solution to identify referral activity based solely on information contained in insurance claims data. Clients use our referral insight to mitigate potentially harmful cascades of wasteful specialty care spending while ensuring that network leakage is kept to a minimum.

Self-Funded Employers

Empower more informed employee decision-making by revealing the highest-value physicians and facilities for their next office visit or procedure. If given the choice, employees are likely to choose providers with high HealthCorum scores, which can be embedded in provider directories or used to complement other employee benefit solutions. Improve outcomes, save money, and reduce absenteeism without disrupting provider networks.

Hospital Systems

More hospitals are contracting with commercial payers that tie payment to performance and partnering directly with employers to provide care on a capitated, predetermined or shared-risk basis. HealthCorum helps hospitals:

  • identify high value providers who are ready for risk-based contracts
  • match the right providers to patient procedures
  • report low value care

ACOs

Establishing a network of high-quality, low-cost providers is a key to risk based ACO success. By partnering with HealthCorum ACOs will lean on their networks of high-quality, cost-efficient providers to improve patient outcomes, reduce costs of care, and achieve shared savings. HealthCorum also helps ACOs develop a high value network of facilities so the ACOs will see shorter lengths of stays and lower hospital readmissions rates, which are two metrics typically used to evaluate ACO performance.