As healthcare in the U.S. is moving towards having more transparency and accountability, the importance of data to heed that shift is also surging. Moreover, with an increase in convenient healthcare products, like smart wearable devices, there is a greater capability to gather data and disseminate results. “We have established processes for finding and collecting the critical data elements and for delivering superior analytics in a speedy manner,” says Jonathan Prince, CEO, Data-Smart Solutions. “Accuracy” and “speed”, claims Prince, are the qualities that guide their engineering arm and produce the services they deliver. Through their comprehensive healthcare data analytics, employers are able to shift from merely collecting the information to compiling and analyzing it to drive valuable results.
DSS’s Clinical Solution Platform (CSP) provides clients with superior ability to risk-score their employee population by assimilating available health and financial data sources into a central resource, facilitating informed and strategic decision making. “We lead the healthcare industry in helping clients identify those employees who are most likely to become the highest cost claimants in the next twelve months,” remarks Prince.
As most of these claimants are not repeats from the previous year, identifying prospective health risk employees from claims data alone is insufficient.
We lead the healthcare industry in helping clients identify those employees who are most likely to become the highest cost claimants
“In fact, biometrics, vision, and health risk assessment information things like Body Mass Index (BMI), blood pressure, and lab results can prove to be a more valuable predictor than past medical claims data,” Prince notes. Once having prioritized a population by risk, employers can focus their resources by applying early intervention to the highest priority cases, thus significantly improving the health of plan members and their bottom line.
The company has built relationships and data pipelines to gather, compile, and analyze medical data that enable employers to make decisions which leads to significant return on investment (ROI). Their industry-focused products have helped customers meet their unique needs, having served entities ranging in size from large to small, including state governments, trade associations, and tiny local restaurants. This is illustrated by the significant savings virtually all of DataSmart’s clients realize when compared to national healthcare cost averages. Through superior data aggregation and integration, DataSmart Solutions also analyzes alternative pharmacy benefit management (PBM) programs and optimizes benefit plan designs to prevent unnecessary expenditures and provider utilization. Customers monitor their high risk members for more efficient case management.
DSS, with its predictive analytics capabilities, has been able to combine statistically-beneficial non-claims data and historical claims information to produce powerful tools that detect near-term high-risk claimants. Focusing on improving their analytics by continuously reviewing new data elements with potential statistical lift, DataSmart Solutions is well poised for a significant improvement in the modeling power and risk scoring ability which they deliver to their clients.