Cost and Utilization Management

Track your entire population and the total cost of care across facilities, providers, DRGs, specialties and many additional dimensions.

The Cost and Utilization Analysis functions of Arcadia Analytics allow you to see patterns and trends for your emergency care population through interactive geographical maps, graphical data visuals, and side-by-side comparisons of data. Measure sets that may be included within your implementation include:

  • Medical Expense Management Dashboard
  • Utilization Analysis
  • ED Detail
  • ED Frequent Flyer Report

We deploy our Analytics tools to collect inpatient data and develop baselines of Potentially Preventable Complications (PPC) and Potentially Preventable Readmissions (PPR). In addition, we develop reports to target system-specific readmission causes. Some typical steps we use to identify patients at high risk for readmissions are:

  • Using appropriate care data to develop a database surrounding patients re-admitted in the past two years
  • Running data through Adjusted Clinical Groups (ACG) software to determine risk scores
  • Implementing targeted processes on patients with identified readmission risk
  • Developing tracking tools to monitor compliance of patients on high-risk listing

Patients can be stratified into various stages across the spectrum of health:

  • Those who are well need to maintain preventative care
  • Those with health risks requiring active behavior change
  • Those with chronic conditions where a focus on care gaps is key

We can help you improve efficiency and care management via optimized, specialty-specific workflows and accurate streamlined documentation. This enhances coordination with all members of the patient’s care team.