Medicare/Medicaid Intelligence

Many health plans find it difficult to maneuver their way through the vast amounts of data they collect.  There is reporting to government agencies, HEDIS reporting, Provider reporting, etc, etc.  As a result of the varying requirements many times health plans create multiple disjointed database and reporting environments that over time become difficult to maintain and understand.

That’s where Lucid Analytics’ Medicare/Medicaid Intelligence Solution comes in.  Built entirely on the SAS Intelligence Platform, this solution is intended to put a stop to the chaos and bring order and simplicity to the Health Plan data environment.  The solution includes: 

• Executive Dashboard with predetermined and/or client defined KPIs and metrics
• Pre-built data inputs for industry standard file formats including HIPAA validation
• Data quality/cleansing at every stage
• Pre-defined Medicare/Medicaid specific data model
• Pre-built ETL routines to populate the data model
• Pre-defined “marts” to facilitate reporting and analytics
• Highly robust and scalable software platform that grows as your business grows

Soon after implementing the solution Health Plans will be able to easily do:

o  Track performance of industry-standard KPIs on a pre-built but customizable dashboard

o  Seamlessly and quickly integrate data from multiple industry standard sources through pre-built ETL input routines

o  Analyze data quickly and effectively from a pre-defined data model and pre-defined specialty “marts”

o  Quantify and stratify member-level profitability

o  Facilitate prediction of interventions for special needs populations

o  Intelligently target areas of most profitable business growth

o  Reconcile premium at the member level (i.e. published rates versus premium received)‏

o  Quickly identify anomalies in the membership roster

For more information please contact us.