Health Care Analytics


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Health Care Analytics

  1. 1. The ABCs of ACO – Balance is Tipping Toward New Revenue Models
  2. 2. Types of ACOs and some Numbers
  3. 3. How We Can Make a Difference
  4. 4. We would like to Enable our partners Take Track 2 With our Trusted Analytical Insights
  5. 5. What Does the Regulator SayA critical foundation of the proposed rule is itsunwavering focus on patients. We envision thatsuccessful ACOs will honor individual preferences and willengage patients in shared decision making aboutdiagnostic and therapeutic options. Informationmanagement — making sure patients and all healthcare providers have the right information at thepoint of care — will be a core competency of ACOs.Held to rigorous quality standards, ACOs will be expectedto be proactive in their orientation and to regularlyreach out to patients to help them meet their needs forpreventive and chronic health care.
  6. 6. What Do Analysts Say Two dominant market vectors: 1) Changes in reimbursement and associated risk. 2) Regulatory requirements (MU attestation, quality reporting etc.) Analytics using clinical data is in its infancy. Clinical datasets are typically a mess and very difficult to work with. For foreseeable future, most healthcare organizations will need to rely on claims data to ascertain risk. We may be years away from doing true real-time analytics with clinical data. Most healthcare providers do not have well-trained informatists on staff (particularly problematic for smaller healthcare organizations) and thus “analytic offerings” will have a high service component. Business intelligence (BI) tools are not well-developed (either too simplistic or too complex for average clinician) and thus clinicians are unable to run their own reports. This has led to IT departments being completely overwhelmed with clinicians asking for various reports. Those pretty dashboards that are based on clinical data which you see at trade shows and in PowerPoint presentations can rarely be replicated at a client site – lots of smoke and mirrors. Most EHR vendors are just getting started in this area and their solutions are rudimentary.
  7. 7. Market OpportunityAccountable Care Analytics Solutions/Products (ACS)  Focuseson selling Analytics Consulting & technology to support thetransition to ACO i.e. Performance/Metric based value propositionfor Providers and Patients. The ACO service market is expected torange from ~$12B to ~$20B in 2016, with ~750 ACOs insome stage of development by that time.We would like to partner with Provider Organizations taking theleap and also payers that are taking baby steps in this space
  8. 8. Consulting Proposal – Improved Health OutcomesOur ACO Optimization Tool Kit will encompass thefollowing Analytical Capabilities: Preliminary Predicting Revisits Clustering of High Risk Population for Outreach and monitoring Care Process Optimization Opportunity Identification & Selection Clinical Analytics/Epidemiology – Population Health Management Solution Post Discharge and Acute Care Outreach Operations Risk and Design Requireme nt Manageme nt Solution Solution Testing and Implementat Deployment ion
  9. 9. Product Proposal – Improved Care Outcomes by Decision Support Our ACO-ASK™ Solution would be a next generation Decision Support System built with following capabilities : Holds Repository of all Medical Dictionaries/Medical Journals Data Model can import Claim/Clinical data for any new population Uses Text Mining and Bayesian Belief Networks Built with Machine Learning Paradigm Supports Voice and Text Interface
  10. 10. High Level System Design
  11. 11. Thin Client Sneak Preview
  12. 12. TECHNIQUES to be USED Techniques Error / MeasureConsulting -Improved Health KNN Root Mean SquareOutcomes Neural Net Bench Mark Error Text Mining Cosine DistanceACO-ASK™ - Bayesian BeliefImproved Care NetworkOutcomes Neural Net Decision TreePatient Satisfaction Sentiment Analysis
  13. 13. Revenue Projections Revenue Projections for Consulting Engagement1098 7 $212,000,000.006No. of clients 5 $159,000,000.004 3 $106,000,000.00 2 1 $53,000,000.000 $26,500,000.00 2012 2013 2014 2015 2016 2017 2018-1
  14. 14. Revenue Projections Revenue Projections (Consulting + ACO ASK™) $250,000,000 $200,000,000 $150,000,000Revenue $100,000,000 $50,000,000 $0 2013 2014 2015 2016 2017 Year
  15. 15. Living Healthy Saving Costs
  16. 16. International School of Engineering 2-56/2/19, Khanamet, Madhapur, Hyderabad - 500 081 For Individuals: +91-9177585755 or 040-65743991 For Corporates: +91-9618483483 Web: Facebook: Twitter: YouTube: SlideShare: LinkedIn: of-engineeringThis presentation may contain references to findings of various reports available in the public domain. INSOFE makes no representation as to their accuracy or that theorganization subscribes to those findings.The best place for students to learn Applied Engineering