Plan Analytics and Reporting

The Deerwalk Plan Analytics and Reporting product offers innovative ways to analyze healthcare data, from both the clinical and financial perspective. Industry standard reports focus on utilization and cost for areas such as places of service, diagnoses, procedures, providers and drugs. Clients can leverage flexible and customizable reporting options to analyze trends in their healthcare spending and utilization by performing streamlined, on-the-fly analysis, from the aggregate book of business level down to the individual member. The unique technological architecture behind Deerwalk’s solutions allows for generating reports in minutes, or even seconds, rather than hours.

Predictive Modeling

Deerwalk's concurrent and prospective risk scores helps identify individuals with the highest risk as well as those with emerging risks that otherwise might go undetected until the full onset of illness. Coupling high-risk stratification with integrated care management and appropriate system support can increase opportunities for proactive interventions, leading to improved outcomes and decreased healthcare costs. On-going monitoring of targeted interventions for at-risk and high-risk members through analytic tools in Deerwalk Care Manager and Deerwalk Plan Analytics allows for comprehensive, efficient analysis of program trends, risks and opportunities.

Prescriptive Analytics

After identifying issues or potential problems within the platform's diagnostic and predictive capabilities, Deerwalk Plan Analytics also offers prescriptive analytics focused on the identification of actionable insights and the potential savings associated with those insights based on the implementation of possible solutions. Deerwalk has incorporated and highlighted several prescriptive savings opportunities within our Plan Analytics application, including prescriptions on drug switch opportunities, place-of-service switch opportunities, and avoidable ER and admissions reporting.

Medicare Reference Pricing

As more and more employers, health plans, TPA's and brokers consider a move toward reference-based pricing strategies in their plan designs, there is an increasing demand to analyze plan allowed amounts against Medicare pricing equivalencies. This can take a lot of time and manual effort, and the comparison output is often inaccurate and unreliable, as regional pricing, place of service, gap-filling when no Medicare price exists, and other factors need to be taken into account for an accurate comparison. Deerwalk has simplified the process by fully integrating and automating accurate Medicare benchmark pricing information directly into the Deerwalk Plan Analytics product.

Data Warehousing

Deerwalk provides a client-friendly solution for housing data of virtually any type. When Deerwalk builds a data warehouse or data lake we focus on creating a data structure that is actionable and supports the client’s analytic and reporting needs. Information from disparate sources such as medical, pharmacy and lab claims; eligibility records; Health Risk Assessments (HRAs) and Electronic Medical Records (EMRs) is brought together in a cohesive database. Data can be mapped into a Deerwalk-defined standard format or to a format the client requests, with frequency of data updates determined by client need rather than any built-in limitation.

Population Health Management

Deerwalk provides a complete suite of population health management solutions on a single, fully integrated platform. Client data is integrated from the patient-generated member portal level all the way up to high-level financial and clinical analytics. The platform enables a wide range of stakeholders and healthcare providers to work in concert with members to manage personal health at the population level. Deerwalk provides the flexibility to meet the needs of any client, the speed to save valuable time at every step in the health management process and the technological know-how and industry experience to ensure that clients are prepared for what's needed now as well as what's next.

Provider Profiling and Reporting

The Deerwalk Plan Analytics product makes provider profiling simple. For clients whose members are assigned a Primary Care Provider (PCP), standard and ad-hoc reporting at the PCP level provides actionable information. For clients who do not use assigned providers but would like to do some provider profiling, the Deerwalk patient attribution model assigns members to a provider so profiling can be completed.

Care Management

The Deerwalk Care Manager product was designed by a clinical team with real-life care management experience and built with ease-of-use in mind to minimize or eliminate workflow interruption. It supports a comprehensive view of an individual across the healthcare continuum and uses a single online record for all care coordination activities. This eliminates redundancy and facilitates consistent, efficient and effective utilization of clinical resources. System-generated care alerts and risk scores aid users in identifying members who are at the greatest risk so interventions can be conducted proactively. Finally, reporting within the Deerwalk Care Management platform allows organizations to evaluate the effectiveness and productivity of interventions and health management programs.

Utilization Management

Coordination of care is emerging as a major component of U.S. healthcare delivery models, not only as a means of improving quality of care but also for controlling healthcare costs. Deerwalk Care Manager is designed to support all aspects of the care coordination process, with special emphasis on Utilization Management (UM). The UM module in Care Manager supports proactive intervention that yields results for members, involved health care providers and Deerwalk clients.

Outcome Measurement

Measuring return on investment in healthcare means more than just counting dollars. Deerwalk understands that, in the changing U.S. healthcare landscape, value propositions are increasingly determined by health and productivity outcomes. Our integrated, data-driven approach to population health management includes an ever-expanding suite of clinically driven reports that allow stakeholders to drill down past the dollars to the true bottom line. From utilization to claims to clinical care, customized solutions and flexible reporting at every level of the Deerwalk platform provide clients the tools they need to take action in the new healthcare paradigm.

Gaps in Care

The Deerwalk Plan Analytics and Reporting product offers an extensive and always-growing library of quality metrics derived from evidence-based medicine and national quality standards. The library features three types of metrics against which care gap reporting can be performed: condition-specific metrics, population management-focused metrics and risk triggers. In addition, client-specific quality measures can be built to support unique needs. Care gaps can be queried and viewed over time or by parameters such as Primary Care Provider (PCP) or group. For clients who choose to use multiple Deerwalk products, solutions are integrated with one another so that care alerts from claims can be incorporated immediately into the member’s record viewing and/or taking action in the Deerwalk Care Management or Member Portal platforms.

360 Degree View of Members

No single type of data can provide a complete picture of a member's health. Deerwalk’s solution to this problem is to be flexible enough to integrate all types of client data within one platform to give clients a full 360-degree view of members’ health and costs. Data can include medical, pharmacy and lab claims; biometric data and patient generated lifestyle data from HRAs and electronic health records; worker's compensation claims; clinical risk scores; OSHA; dental and vision claims and more. Deerwalk’s integration of data from different streams allows for on-the-fly analytics derived from any data you desire.

Patient-Generated Health Data

Lifestyle and family history information can be entered by members via the Deerwalk Health Portal and integrated across the entire Deerwalk platform, making patient-generated data actionable within the population health management system. Data can be viewed in the HRA format whether the HRA being used is native to Deerwalk HRA or a third party solution that Deerwalk integrates, and our Reporting and Analytics product extracts and scrubs this data to make it available for financial and clinical analytics.

Incentive Management

Incentive Management is a service module that is integrated within the Deerwalk Plan Analytics and Reporting, Care Manager and Health Portal products. With the module, claims generated by wellness or other programs in Deerwalk Plan Analytics and Reporting trigger incentives that are viewable by members in Deerwalk Health Portal and presented to nurses in Deerwalk Care Manager for verification. The Incentive Management module keeps track of progress against goals and allocates rewards and incentives to health plan members upon their completion of health-related activities. The module also supports health incentive-based team competitions within organizations.

Health Risk Assessments

Health Risk Assessments (HRAs) are an integral part of any modern healthcare management system. They enable organizations to consider self-reported member health information, in addition to claims data, when identifying risk and opportunities among the population. In addition, HRA records are essential for evaluating the effectiveness health programs. With Deerwalk, HRA forms are available in practical, structured and intuitive user interfaces in both the Deerwalk Care Manager and Health Portal products. Members self-assess their health by providing responses on an HRA form using the Health Portal. Responses are then available in Deerwalk Care Manager for clinical staff to verify or modify, and in Deerwalk Plan Analytics and Reporting for analysis based on HRA fields. Deerwalk provides a range of assessment forms and our robust architecture fully supports client specific-changes and customization. Deerwalk will integrate a third party’s HRA if the client prefers, and will import third party HRA data to the platform.

Medical Episode Grouper

Medical Episode Grouper (MEG) can be used within Plan Analytics to analyze condition prevalence, cost, and utilization patterns across a population by grouping all of the care for a single medical condition for one patient. Plan Analytics users are able to evaluate specific healthcare events that have been categorized into segments based on geography, demographics, and other patient elements within a population. Episodes are created to assess and differentiate healthcare services provided by professional, facility, both inpatient and outpatient, in addition to prescription drugs. Not only can MEG's define and identify conditions in a population, it can also provide insight on the severity. Episodes are assigned a stage representing the highest level of severity recorded for the disease during that particular episode of care. The expected cost or utilization is adjusted based on the type and severity of episodes being compared. MEG offers an additional adjustment option that not only considers the severity or stage of the episodes being measured, but also the overall illness burden for the patient.

Provider Quality Ratings

The move to value-based care and widespread variability in care means quality measurements now play an integral role in strategic healthcare planning. Industry stakeholders need reliable provider quality information to guide decisions around new payment and delivery models, plan performance and tiering, network management, provider reimbursement, risk management, and contract negotiation. The Provider Quality Rating* module (powered by Quantros) is integrated directly within the Deerwalk Plan Analytics platform and enables clients to distinguish high-value providers from low performers for inpatient care in a specific market, region, or treatment area. Clients can search, filter, and view overall quality scores along with quality ratings across six distinct quality categories (Patient satisfaction | Patient safety | Inpatient quality | Mortality rates | Complication rates | Readmission rates) and more than 30 clinical categories. From advising members on where to go for services to evaluating providers and understanding the outcomes of where members receive care, quality information is essential for successful, proactive management of the healthcare of a population.