Program Evaluating ROI
Visual Intelligence developed a unique analytical framework that captures, measures and monitors outcomes for various patient populations across time. Combining techniques of Visual Data Analysis and Predictive Analytics, Visual Intelligence has created a conceptual model that can be used by clinicians, health economists, actuaries and other decision makers involved in health care managing and financing aspects. dmVIews is a comprehensive Disease Management and Care Management analytic tool that evaluates the effectiveness of a wellness program offering unsurpassed levels of insight in to those members of your population that are being managed for certain disease conditions. The tool brings together large volumes of clinical and administrative data and key patient information including:
- Eligibility, Demographic, Socio-Economic, Geographic
- Inpatient medical claims, Outpatient medical claims, Professional medical claims
- Pharmacy claims, Lab tests
Disease/Care Management Information:
- Data processes and identification algorithms for Diseases (e.g. Asthma, Diabetes, CHF, COPD, Hypertension, Cancer)
- Risk adjusted case mix severity scores
- CM Outreach Activity data, including calls, behavioral assessments, Total days in program, etc.
- Servicing Provider, PCP, Facility, IN-OUT Network providers, etc.
dmVIews model uses industry accepted outcome metrics related to medical costs and utilization, drug costs and utilization, treatment compliance and adherence to medication for patients enrolled in chronic disease management programs and other programs. The solution offers the ability to rapidly view, filter, sort, analyze, and report on this data from a variety of perspectives. Examples of basic functionality provided to Analysts include:
- Ability to instantly view summary clinical information of the population by disease condition and all possible managed co-morbidities.
- Ability to analyze Total Aggregate Care Managed Days and Contact Days for all conditions and co-morbidities, then drill down to the individual recipient level with a single click of the mouse.
- Ability to view population Demographic/Socio-Economic characteristics (age, sex, marital status, race/ethnicity, education, occupation, employment status, and income level) in the aggregate by managed condition and drill down to individual recipient level.
- Capability to longitudinally assess and compare Medical Utilization and Medical Cost by program and compare with non-diseased comparison group by PMPM measures, IP visit, Readmission, OP visits, Professional visits, and ER visit rates.
- Capability to longitudinally assess Drug Utilization and Drug Cost by program and compare with non-diseased comparison group and view reports by drug name, dose, mean days supply, script count, MPR, persistent/non-persistent, and poly/single pharmacy.
- View your CM population Geo-spatially by condition/co-morbidity, Facility catchment, Provider/Specialty care access metrics at the state, city, zip level.
- Evaluate the financial performance of disease management programs. Traditionally, the comparison of costs/utilizations is made with what the costs/utilizations “might have been” without the program in place. dmVIews automates the most difficult part of these types of evaluations. dmViews uses three – four years of claims data to compare chronic trend with non-chronic trend for the same population as being intervened currently:
- By comparing risk-adjusted non-chronic and chronic trends in historical time periods using identification methodologies identical to those in the program period.
- By comparing the risk-adjusted non-chronic trend for the program period, and then modify it to represent a “what might have been” chronic trend.