Milliman PRM Analytics — Care Coordinator Reports

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The Care Coordinator Reports are opportunity-based population analytics reports that provide risk-bearing organizations with the information needed to make better decisions. This tool summarizes claims and demographic data, and through predictive analytics, identifies opportunities for care management improvement and reduction in potentially avoidable costs.

The Care Coordinator Reports are backed by more than 65 years of experience in healthcare consulting, data analytics, operational analysis, and problem solving. The solutions offered by this tool leverage a unique reporting structure and custom analytics that will help meet coming healthcare challenges head-on.

A custom view

The Care Coordinator Reports provide an efficient, statistically sound approach for stratifying and prioritizing an accountable care organization’s patient population, allowing care coordinators to focus their patient acuity assessments on the patients with the most opportunity.

The Care Coordinator Reports produce opportunity prospective scores for patients that are estimates of each patient’s medical experience over the next six months absent intervention. The scores are estimated by applying predictive analytics to an ACO’s historical patient information. The resulting reports are based on data specific to the population the ACO is managing.

With pre-defined filters, the user can quickly drill down to the individual patient level. The resulting data will help determine the best care management approach to reduce potentially avoidable costs.

The Care Coordinator Reports include the following sections:

  • Filter Population – Displays demographics about the entire or sub-segments of the population
  • Population Report – Contains information at the patient level to facilitate the assignment of care coordinators to patients
  • Excluded Report – Lists patients that are known about but are not relevant to the current report ( i.e., may not have recent eligibility or complete claims history)
  • Patient Profile Report – Available once a particular patient is selected from the Population Report. Contains information at the patient level to facilitate care coordination.

Next steps

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Milliman PRM Analytics