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.
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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