Doctor checking a patients preasure.

Provider Management

Informed referrals. Superior network sculpting.

Arrows headed downwards. Caduceus arrow headed upwards.

A shift in approach.

Attempts to measure provider performance have been in place for decades. Uncovering actionable insights and presenting the analytics to key stakeholders continues to be a challenge. We have combined state-of-the-art analytics with action-oriented technology to improve performance.

Medical builds in a city block.

Optimize referrals.

Encouraging PCPs to refer to high quality, cost effective specialists requires a combination of science and art. Provider Spotlight promotes rapid, focused, insightful provider communications to encourage the optimal referral behavior.

Man trimming a tree with medical items.

Sculpt your network.

Simply displaying cost and utilization indices that compare performance to risk or casemix adjusted averages do not provide enough depth or insight to motivate a provider to change behavior. We provide a collaborative platform that measures performance by differentiating members not only by their disease and utilization history, but also by their engagement patterns, social determinants of health, and access / satisfaction.

A bar graph with a shinning crown in the top center.

Improvement through insight.

Provider Spotlight delivers insights to help the plan, provider, and member work together to improve outcomes. We deploy the latest case-mix and risk adjustment technologies to adjust for patient severity, and balance these insights with relevant, peer-reviewed quality metrics. The result: an equitable and actionable assessment of provider behavior.

Provider Spotlight portal.

OPUS

Actionable provider insights that supercharge performance.

Provider Spotlight delivers an at-a-glance view of a provider’s cost, utilization, and quality performance enabling the plan, provider, and member to work together to improve outcomes.

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