Utilization Pattern Analysis

Utilization Pattern Analysis

What

Our analytics assess dominant utilization patterns and how they relate to clinical characteristics. The analytics flag unexpected cases for further investigation.

utilization

Highlights

  • Identification of dominant utilization groups through customized patient segmentation algorithm
  • Construction of predictive models linking clinical characteristics to expected utilization
  • Identification of unexpected cases via comparison between expected and actual utilization groups for each patient

Value

  • Provider: enable management by exception by allowing focused investigations into significant unexpected practice variations
  • Payer: insight to help guide disease management program design and fraud detection

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