How should data be analyzed and reported in a risk-contracting environment?
Integrated delivery systems (IDSs) that enter into risk contracts with payers need sophisticated data analysis and reporting capabilities to ensure proper payment and to manage utilization. An IDS can develop these capabilities by following a six-step process: It should develop an IDS data management structure, obtain all requisite data, review and refine the data, consolidate the data, create a relational database, and develop a reporting structure. The reporting structure should consist of a set of standard reports and the ability to generate additional targeted reports that facilitate analysis of specific aspects of utilization and financial performance.
Pearce
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Dan Grauman Associates, Inc., Bala Cynwyd, PA, USA.
Kaye
J
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D002204:Capitation Fee; D003365:Costs and Cost Analysis; D003625:Data Collection / Q000379:methods; D003627:Data Interpretation, Statistical; D003628:Database Management Systems; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000458:organization & administration*; D007345:Insurance Claim Review; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data; D012308:Risk Management / Q000379:methods*; D012985:Software Design; D014481:United States