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How to embrace the move to value-based care

Advanced health analytics solutions turn grey areas into golden opportunities to contain costs, enhance performance and improve patient outcomes.

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Innovations in population health management

~$42B

Roughly $42 billion prospectively risk-adjusted

Roughly $42 billion in managed care premiums are prospectively risk-adjusted using Solventum™ Clinical Risk Groups (CRGs) annually.

Like maths, medicine is a science. Unlike maths, with medicine, problems don’t have one correct answer. Variations from case to case make it difficult to apply uniform treatment. Yet healthcare systems are challenged to efficiently serve every stakeholder, provide appropriate care to each patient, and charge accordingly.

This is where our proprietary patient classification methodologies and grouper applications bring order to what might otherwise be chaos. By stratifying patients based on risk, clinical characteristics, and other metrics, these groundbreaking solutions replace the grey areas with a common language that healthcare systems, payers, providers, and regulatory agents can share.

They can also energise your entire enterprise, and multiply your ability to contain costs, enhance facility performance, and significantly improve population health.

Which is the kind of maths both medicine and healthcare can appreciate.

Drive your organisation’s shift to value-based care

Whether dealing with inpatient or outpatient populations, grouping applications allow for better cost management, quality enhancement, performance assessment, and data-driven decision-making.

Improve population health outcomes and measure risk adjustment

Actionable analytics and risk adjustment data simplify provider performance comparisons, making it easier to establish accurate payment models, implement timely interventions, and make more informed decisions.

Enhance workflows via accurate data and real-time reporting

Different teams can collaborate seamlessly to identify gaps and address them, resulting in more precise documentation, improved financial benefits, quality scores, and more.

Predict and verify reimbursement

Reliably forecast healthcare costs and drive accurate coding, and reimbursement amounts.

Help identify and track trending social determinants of health (SDoH) and health-related social needs (HRSN)

Our software detects relevant SDoH/HRSN data to assist you in creating targeted interventions, efficiently allocating resources, improving care quality, containing costs, and promoting greater health equity.

Measure facility performance with analytics and reporting

Gain the detailed insights required to optimise resource management, compliance, risk management, predictive analytics, quality of care, and more, identifying every opportunity for improvement.

Egyptian Health: Strengthening care coordination for at-risk kids

On a mission to enhance quality and cut costs, Illinois' Egyptian Health Department embarked on a project to screen 11,000 Medicaid and/or CHIP recipients through phone and in-person interviews — but soon discovered that this approach didn’t provide the complete picture. However, with Clinical Risk Groups (CRGs), the organisation was able to validate complexities, meet Alternate Payment Method (APM) performance measures, and uncover risk profiles that might have otherwise been missed, thereby identifying at-risk clients.

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51%

A 51% reduction in potentially preventable complications by using Solventum™ Potentially Preventable Complication (PPC) Grouping Software, according to an assessment from Maryland Health Servicesopens in a new tab.

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32 states 
32 states use one or more proprietary methodologies for payment, reporting, risk adjustment or quality measurement.