As the payers examine invoices from the providers of services such as doctors, hospitals, emergency care clinics, home healthcare agencies, elderly care facilities, etc. with a highly trained magnifying glass, these providers are forced into practicing and evolving a far more optimum business model. One of the more worthwhile and often neglected tool is data.
We at Anji Technologies LLC have assisted some of our clients in this space in optimizing their operations by delivering analytics and insights into their practice areas to:
- Receive maximum and timely reimbursements
- Develop operating models that are cost relevant and deliver high value to the patient
- Integrate to optimize and eliminate redundant platforms for a more efficient delivery model
At Anji Technologies LLC, we clearly understand the impacts ACA is and will continue to have as the model shifts from a “pay-for-service” model to a “wellness” model. We understand how data will need to be managed, how the reporting function will need to be utilized and finally how the necessary indicators will need to be delivered to receive payments for the services rendered.For providers large and small, the comparisons will need to shift from the local models to “national norms” and for that adaptations, competitive algorithms and relevant analytic model will need to be developed and evolved to enable the providers of services to deliver care accordingly.
Case Studies :
Healthcare sector has been one of the major player in implementing Advanced Information Technology and healthcare customers continuously keeps revamping in order to stay in business due to steep competition and provide unmatched customer satisfaction.
One of our healthcare clients was facing issues like shrinking revenue, falling customer satisfaction and increase in unearned revenues.
We at Anji Technologies identified various causes for these issues. One such cause was large variations in patient inflow which led to under-utilization of resources that finally resulted in lower revenue. Another cause was the delay in transfer of patients to a specialized care. This not only resulted in a lower level of customer satisfaction but also affected admission of new patients. The cause for increase in unearned revenues was identified as the large revenue cycles on pharmacy claims especially in certain specialized areas.
Anji Technologies’ analytics team developed a data governance solution that standardized master data across various departments. Our visualizations and ad-hoc analysis provided capabilities to the client to visualize and identify problem areas proactively and stream line B2B transactions. Our machine learning models predicted an incoming patient’s length of stay and outcomes to effectively manage demand and supply of the client.