Health Fabric™ Data Activation Platform with Payer Analytics

Transform your data and take action with MedeAnalytics Health Fabric™, the first fully curated, turnkey data activation and enrichment platform built with industry-standard healthcare data models. Once your data has been ingested, cleansed and normalized in our secure platform, all financial, operational and clinical data is available to your organization in an enterprise single source of truth. Utilize our AI-powered, Integrated Analytics solutions and Data Science Factory™ to transform operations and streamline workflow, addressing complex business needs such as:

• Incorporate third-party groupers, SDOH data and custom cohort options into one view to identify gaps in care and support at-risk members with population health risk stratification
• Assess member risk and utilization and quality of care opportunities through HEDIS® and other quality standards
• Improve member engagement and outcomes through targeted interventions
• Gain visibility into provider performance with detailed views of peer-to-peer efficiencies, cost patterns and utilization trends.
• See an integrated view of plan performance to understand opportunities and redirect members to more appropriate levels of care.

Improve operational efficiency and enhance your ability to provide value-based care, align payer operations with broader healthcare goals by pairing proven strategies and frameworks with AI-powered technology, including:

Quality Insights: Prioritize population health and health equity investments by identifying quality of care opportunities through HEDIS® and other quality standards. Address key drivers of performance through social determinants data, risk scoring, and provider attribution.

Employer Insights: Elevate data sharing with employer groups to demonstrate value and increase efficacy of risk stratification and care management plans. Leverage customizable benchmark datasets for advanced forecasting and cohort management.

Network Insights: Accelerate provider performance with evidence-based outcomes comparisons, cost-effectiveness analyses, and extensive segmentation capabilities. Negotiate contracts more effectively and engage providers through dynamic, real-time scorecards.

Integrated Patient Insights: Seamlessly incorporates vital information at the point of care, including care gaps, coding gaps, and population health and social risks.

Social Risk Insights: Gain a better understanding of the factors, risks and needs of your population. See a 360 view of your members, allocate resources based on accurate information, and effectively execute advanced risk stratification, care coordination and population health management.

Value-Based Care Administration: Combine powerful analytics with contract and payment management capabilities to enhance value-based outcomes through data driven insights, performance optimization, and seamless fund transfers.

Medicaid Enterprise Analytics: Uncover insights from claim and clinical data, providing the foundation for MCOs and agencies to collaborate and help deliver better outcomes to underserved populations.

Managed Action™ with MedeAchieve: Turn your insights into action with our patent-pending closed-loop solution for enterprise performance management. Create dynamic, action-driven plans that connect to organizational goals and key performance indicators to drive strategy execution, accountability and alignment.

By leveraging modern tools and frameworks, along with expert consultation from our Strategic Advisory services, MedeAnalytics enables organizations to navigate the complexities of modern healthcare, from regulatory compliance to AI modeling, all while maintaining a laser focus on enhancing care and optimizing financial outcomes. In an industry where data-driven decision-making is paramount, we are a trusted partner, guiding healthcare payers toward a future of improved efficiency, better member outcomes, and sustainable growth.