• What are our network providers' cost trends?
  
• What is driving health services utilization?
  
• What intervention programs will work for our high-cost conditions?
  
• Is our disease management program delivering a return on investment?

What are our network providers' cost trends?

By using system alerts, quick problem analysis, and indicator reports that uncover what’s happening, you can:

• Effectively monitor and manage clinical risk and administrative overhead
• Examine treatment outcomes, resource consumption, prescribing patterns, access issues, and payment history

What is driving health services utilization?

By using root cause analysis to determine why a pattern is occurring, you can:

• Examine utilization by geography, member, physician, and site of service, and determine the high-prevalence conditions prompting frequent treatment
• Review effectiveness of preventive care
• Determine if complications of care and adverse events are causing readmissions, resource drains, and financial risk

What intervention programs will work for our high-cost conditions?

By using cost-benefit modeling to provide decision alternatives and guide selection of the right solution, you can:

• Determine level of disease severity for specified high-cost conditions to evaluate program alternatives
• Study compliance with prescribed treatment plans, and determine cost-effectiveness of pharmaceutical, programmatic, and preventive remedies
• Select measurement criteria for success evaluation

Is our disease management program delivering a return on investment?

By using tracking, trend analysis, and benchmark comparisons to evaluate your solution, you can.

• Examine compliance with specified treatment plans
• Compare number of care treatment episodes before and after program implementation
• Measure cost saving results against forecasted program returns