Comprehensive Financial Measurement and Analytics

 

Performing initial analytics on several years of your claims and utilization data is an intricate part of our solution and enables us to identify immediate savings opportunities. Post implementation you receive regular reports detailing measurements of your ROI, including savings and value of implemented solutions.

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MDamerica utilizes a robust engine of financial management and analytics tools to:

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• Calculate your ROI and provide comprehensive reporting of savings

• Mensurable cost reductions in CCM, Rx, Office Visits, ER visits, Lab/DME/Diagnostics

• Identify health cost drivers

• Monitor population health

• Optimize contracted network needs with cost effectiveness and review TPA/Payer contract

• Model plan designs and implement CCM and discounted Rx/Lab/DME/Diagnostics programs to control benefit costs

• Identify and recover claims payment errors

• Provide comprehensive financial and utilization reporting: plan cost, employee cost vs benchmark, primary/specialist/inpatient/outpatient/ER, in-network vs out-of-network, Rx, outlier, stop-loss, and much more