Success Story

Delivering the Data that Drives Value-Based Care Initiatives

Problem: Value-Based Care Requires a New Type of Data Analysis

The landscape in the healthcare ecosystem is rapidly evolving from fee-for-service to value-based care (VBC). For the first time, payers and providers are completely aligned as they collaborate to improve outcomes and cost savings. 

To achieve these new arrangements, health plans must now analyze their data in new and different ways. They must identify episode categories, determine which provider locations receive the greatest volume of referrals, and factor in costs to help patients receive the highest value of service. This information then drives discussions of new value-based care contracts between payers and providers.

But, due to the massive quantities of data, many companies are unable to gather this information in a way that is streamlined and user-friendly.  

Solution: Creating Definitions and Implementing Groupers

SourcEdge is an expert in analyzing and organizing massive amounts of data. Our analytics shine the light on the costs of episodes of care and help payers identify how to launch their value-based care programs. 

We work with clients to provide cloud-based data analytics as well as build specific episode definitions and implement episode groupers to create the data output.

We then take that raw data and deliver it in a file-based, self-service architecture, which allows clients to build their own visualization and reporting from this enhanced data set. 

SourcEdge’s Role: Building Analytics Engines

We pride ourselves on staying up to speed with the hottest trends in the market. 

For one client, we built the analytics engine that supported their value-based care contracts. In another project, we built a cloud-based analytics platform specifically around a condition that the client wanted to analyze. 

Value Achieved: Accelerated VBC Initiatives

In each of these cases, clients were able to accelerate their VBC initiatives in the market. As a result, we drove cost and quality improvements while increasing provider adoption and engagement.

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SourcEdge Joins Alivia Analytics

The unified organization combines SourcEdge’s claims system technology optimization expertise with Alivia’s AI-powered payment integrity / FWA data and analytics platform.