Healthcare Analytics

Healthcare Analytics from Medical Healthcare Solutions

A lot of talk has been going on regarding the need for healthcare analytics. The healthcare industry is now recognizing the valuable insight into patient care that can be gained from an examination of the demographics surrounding classification of patients by health condition and the criteria that go into converting your management of high-risk patients into one of the best practices. As we move toward a model of value-based reimbursement structure (fee for value) over volume-based care (fee for service), we experience greater access to larger amounts of data regarding patients: EMRs, billing systems, and health information exchanges to name a few.

As such, data analytics is one area that many organizations are leaning toward in order to achieve their strategic goals. According to recent polls, not even 20% of healthcare organizations have staff trained to collect and analyze the large amounts of patient data on hand. For that, more and more companies are looking to bring physicians into the data analytics process. By nature, physicians already have excellent analytical skills, plus they have the advantage of having inside knowledge of hospitals’ clinical operations.

What’s MIPS?

With the new Medicare physician reimbursement program slated to begin in 2019, MIPS (Merit-Based Payment Incentive System) prompts healthcare providers to offer the best care at the lowest cost to patients. This is where Medical Healthcare Solutions comes in. We have the tools to capture the analytics specific to your practice, and the staff trained to interpret that data for you.This service is a bridge to help healthcare providers like you understand and implement such a big piece of the Value Based Reimbursement puzzle. Before MIPS, base payment rates were set universally and provider performance was not taken into consideration. In preparation for the new incentive-based system, Medicare will continue with automatic rate increases through 2019 but they are also collecting provider performance data. Using the data collected between 2015 and through 2019, provider reimbursement rates will be altered by Medicare based on their performance under a Merit-Based Payment Incentive System (MIPS).

 

The categories of assessment include:

  • Quality
  • Resource use
  • Meaningful use of electronic health records
  • Clinical practice improvement activities

Those doctors who have the lowest performances will see payments reduced by up to 9%. Congress will set the payments for the years 2026 and beyond. Doctors will have to participate in Advance Payment Models (APMs) to determine pay increases. Bottom line is, their composite performance scores (CPS) in a given performance year determine MIPS payment adjustments in the subsequent calendar year.

We Have the Tools You Need

Our healthcare analytic tools are specifically designed for physicians, healthcare administrators and billing professionals, with an easy-to-use reporting process that collects and sorts data from practice management systems, electronic medical records and accounting software systems. No more wasted time spent on manual analysis and reporting! Our tools help you analyze data in the following categories:

  • Accounts receivable
  • Payer performance
  • Practice benchmarking
  • Profitability
  • Quality of care
  • Patient charges, payments, and demographics

Medical Healthcare Solutions can help you prepare for changes occurring as part of Value Based Reimbursements and MIPS. Because of our use of the latest medical billing technology, our expert staff can provide insight into healthcare analytics and how you can make it work for you in your clinical practice. These ever-changing regulations and complex parameters can be confusing for even the most experienced professionals. Let’s make it easier for you.