Predictive Modeling

Our predictive modeling suite offers you the trending analysis you need to support your Healthcare Reform outcomes

DSTHS CareAnalyzer® is an analytic solution that combines patient risk, care gaps, and measures of provider effectiveness within a single solution

Having a solution that combines patient risk, care gaps, and measures of provider effectiveness available allows us to support your healthcare outcomes by: Assisting care managers to more effectively target members who may benefit from care management. Our goal is to reduce the time you spend looking for the appropriate members so that you can better utilize your resources to actually provide the needed care guidance. Continuing to offer the ability to meet HEDIS® regulatory requirements. HEDIS measures support more effective identification of members by noting the gaps in care, so health plans are also able to meet annual HEDIS requirements by using DSTHS CareAnalyzer.

Optimize Medicare Advantage Prescription Drug Plan (MAPD) capitation rates
using DSTHS RiskAnalyzer™

• Identify individual records for medical record abstraction
  • Prioritized by the likely financial return
• Quantify the revenue impact of common coding issues
  • Correct systemic issues in coding to improve future revenue flow
• Reinforce linkage between primary care and risk adjustment

The Johns Hopkins ACG® System - Rx Predictive Model (RxPM™) lets you get the most benefit from the inherent value of your pharmacy data

With The Johns Hopkins ACG® System - Rx Predictive Model (RxPM™) you can use your pharmacy claims for trending analysis of your data. You get full use of your existing data to better support patient care and Healthcare Reform initiatives, including improvement of your Medical Loss Ratios. You can use Rx based risk scores to:

• Take advantage of improved timeliness, completeness and accuracy of pharmacy claims as a data source
• Disease management programs analysis (population analysis & individual identification)
• Identify/Manage complexly ill members (hospital
• Make improved predictions of total cost (pharmacy + Medical) over standard age/sex methods
• Forecast pharmacy costs with improved accuracy
• Identify poly-pharmacy members for MTM

The Johns Hopkins ACG® System - Rx Predictive Model (RxPM™) will help you manage your members when only pharmacy claims are available and when combined with medical claims and the ACG System will further improve the predictive power. Contact us for more information about this tool.

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