provider intelligence

easy, actionable insights

Many provider organizations use DxCG Intelligence on its own because they rely on its scientifically proven models to make critical business decisions and have the expertise and infrastructure required to put the models to work. For others, the comprehensive approach of Provider Intelligence works best. Provider Intelligence puts the DxCG Intelligence risk adjustment and predictive models to work within a solution that helps you get up and running quickly, as well as streamline ongoing monitoring and reporting. With Provider Intelligence, you can quickly determine the best opportunities for cost, quality, and utilization improvement, turning them into short-term cost savings while developing new strategies for achieving long-term, sustainable results.

features


Physician and Clinic Performance Assessment

The solution allows you to fairly evaluate performance based on risk-adjusted values, enabling you to identify the best practices of high-performing physicians, quantify practice variations, and manage quality-based contracting.

In- and Out-of-Network Utilization

To address leakage and other factors influencing spending, Provider Intelligence delivers both graphical and tabular representations of healthcare utilization patterns.

Quality and Risk Measures

Users can monitor and report on NCQA-certified, claims-based HEDIS® and other measures that support pay-for-performance contracting and provider performance evaluation. Case managers can view care gaps and all services received—a real 360-degree view.

Population Monitoring and Program Assessment

Ongoing evaluation of the effectiveness of population health programs through comparison and trending of cost, utilization, and quality metrics optimizes your ACO and at-risk contract performance. Quality and case managers can also identify patients by disease state and risk stratify them to better direct care management and outreach activities, such as a focus on high utilizers of hospital care or emerging-risk patients.

benefits

  • Integrates additional data sources into a single, comprehensive application, delivering critical population-, member-, and provider-level insights
  • Supports areas such as quality improvement, performance management, and out-of-network healthcare usage
  • Puts tailored answers at your fingertips with simple ad hoc query functionality
  • Facilitates communication with easy-to-digest, graphical reports
  • Evaluate the impact that your initiatives are having

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)

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