Hopefully as a provider your group, HMO, or IPA will help assemble some of the new informatics if you are a physician. What this means to the rest of 
us is the potential of one more transaction coming out of that claim that is filed to fill a corporate piggy bank. There’s a lot of 3rd party software out there that are deemed to just have you perform like you have never done it before (grin). Certainly there’s a need for analytics but the field is over crowded and from what i am hearing, the doctors are over indulged right now and the parameters to first of all understand are getting too complicated, yet along collect on any pay for performance carrots.
It would be nice if the government at this point would just wipe out half of this and either create their own program or use 1-2 contractors to get rid of the glut ands save us all some money on Wall Street as these are the guys making million and billions as they are traded. I guess in researching this blog I read so many of these announcements and look at so much software, it all looks the same and heck I have a hard time just getting through EHR and PHR discussions with your average MD so again this is so way over done.
When you look at how analytics are handled today with carrots, even the Meaningful Use folks over shot the barrel, and that I attribute to not enough first hand experience with hands on with real people and situations. We are to the point with complexity of software that you don’t dare 
shoot your mouth off over a “proof of concept” anymore, as we are beyond that and really need folks who “get it”.
The problems are that payers are not certified with their algorithms and formulas and for one they are dumping more private information out there than any EHR has by a long shot, so we don’t have the entire solution and won’t have until we get some of their algorithms to certify that they work and gain trust in what they say and do.
If you look at the clients with MedeAnalytics you will see hospitals and insurers that you probably recognize on the list such as Cleveland Clinic and Blue Shield of California.
It gets back to what I say has been going on for years, it’s a battle of technology and the algorithms, the insurers and Wall Street have machine guns and the rest of us are still running around with swords and daggers. There’s value by all means to analytics and we need it, but there’s also the issue that we might have a number of companies and individuals almost to the point of needing a 12 step program to help with the addiction to the process as money is driving many almost to this edge. BD
EMERYVILLE, Calif., July 22 /PRNewswire/ -- MedeAnalytics, a leading provider of healthcare performance management solutions, announced that it has entered into a multi-year agreement with Health Net, Inc. (NYSE: HNT) to provide performance management solutions for Health Net's health plan operations and Medicare products. The solutions will enhance Health Net's current data analytics capabilities and include Medical Management Analytics, Provider Network Management Analytics and Operations Performance Management.
Medical Management Analytics helps manage medical costs through quality improvement and utilization management. Specific key performance measures include emergency room coding and utilization, readmissions, one-day stays, length-of-stay efficiency and asthma therapy.
Medical Management Analytics helps manage medical costs through quality improvement and utilization management. Specific key performance measures include emergency room coding and utilization, readmissions, one-day stays, length-of-stay efficiency and asthma
therapy.
Provider Network Management Analytics provides a deep understanding of the network providers and their performance. This includes outcomes, provider practice patterns and identification of outliers.
Operations Performance Management leverages insight into metrics that must be monitored by health plans, such as claims processing, denials and appeals. Examples include volumes of claims processed, how long it takes to process a claim, denial rates and overturned appeal rates.
"The current economic and regulatory environment is placing increased demands on payers," said Scott Paddock, senior vice president, Payer Solutions. "As a result, payers such as Health Net are moving to ensure that they have responsive, dynamic business intelligence capabilities that, when combined with workflow and document management, yield superior performance management. Our payer clients span the U.S., and we are pleased to help them control costs and navigate these challenging waters."
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