Today’s healthcare system is transitioning from a traditional fee-for-service model to a value-based revenue model. A comprehensive management strategy for the new revenue model requires an entity to be part risk manager, clinical manager, financial manager, and resource/operations manager. Milliman PRM Analytics® was specifically developed to support the various roles inherent to value-based revenue.
Milliman PRM Analytics provides insight into actuarial risk and clinical opportunity. PRM connects the clinical characteristics of the patient with the estimated actuarial value that may be derived from the management of that patient. This allows for an entity to strategically select and manage patients for the best opportunity to reduce risk.
Milliman PRM Analytics is a scalable solution with the capacity to scale with additional applications through the PRM Power Application Grid. You can choose to add a little or a lot.
Predictive Analytics Solution
Milliman PRM Analytics is a predictive analytics solution capable of predicting any number of healthcare management risks. The primary predictive analytics are the Opportunity Prospective Scores.
Patient Care Management
Milliman PRM Analytics is not a standalone solution. It can also be integrated with an existing care management system for comprehensive care management. The PRM Care Coordinator Reports provide care managers with a comprehensive view of recent patient clinical and claims activity, making management more efficient and effective.
The Milliman PRM Analytics Physician Risk and Credibility Adjusted (PRCA) reports benchmark physician performance in a complete actuarially adjusted manner. This allows for a common basis upon which to review physician behavior and performance among peers as well as against benchmarks. PRCA, combined with other modules available from PRM, provides insight into physician behavior only rivaled by comprehensive and time intensive clinical chart reviews.
Milliman PRM Analytics is a quality metrics solution that can create any claims, clinical, or hybrid quality metrics defined by the customer. Clinical and hybrid quality metrics require a clinical data repository. Ongoing calculations provide an advance look at your quality scores so that gaps can be identified and proactive action taken.
Clinical Data Repository
Milliman PRM Analytics can integrate clinical and payer claims data into a central data repository.