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Actionable Healthcare Analytics

Mile High Healthcare Analytics helps health plans, financial risk-bearing provider groups, and vendors tackle the challenges of a constantly evolving payments landscape.  We focus exclusively on government-regulated health plans; Medicare Advantage, Medicaid managed care organizations, and the health insurance exchanges, tracking policies and best practices closely so that we can help clients with their toughest risk adjustment and quality improvement issues.

We bring a practical, data-driven approach to help clients successfully navigate the transition toward value-based payments. We can help your organization achieve financial and clinical optimization through improved:

  • Premium Payment Accuracy
  • Precision Targeting of Care Deficiencies and Documentation Gaps
  • Quality Ratings
  • Provider Engagement
  • Payment System Mastery

Our predictive risk adjustment analytics and quality improvement analytics are built around client capabilities and a deep understanding of clinical medicine and the managed care industry.  We are keenly focused on helping clients prioritize activities that will yield the highest return with the least amount of organizational upheaval.

 

It Starts with Your Data

Mile High Healthcare Analytics understands that data integrity is critical to risk adjustment and quality improvement success.  In fact, data governance is the starting point for nearly every client engagement.  We help provide data governance down to the individual member level addressing the root causes of data inaccuracy.  Where needed we will perform detailed evaluations of your end-to-end data management process to uncover issues that hinder your ability to correctly understand and address data gaps such as:

  • Year over year comparisons that fail to account for changes in NCQA specifications
  • Absence of data for commercial QRS measures
  • Lack of quality control on Member-level/service-level data files
  • Incomplete NDC codes on pharmacy claims
  • Clinical laboratory files missing LOINC codes
  • Incomplete data on utilization
  • Member/Provider identifier inaccuracies

The Mile High team is able to clean, process and analyze large and complex data sets. Because we understand the data and manipulate it ourselves, we ensure the validity of the results from our analytics and the applicability of the data to achieve client objectives.

 

Cortex-QM

Meeting and exceeding CMS quality standards has never been more important for providers and plans alike.  Since the institution of the Medicare Advantage Star Rating system, scores have been steadily rising as players across the healthcare ecosystem recognize the impact of these ratings on both consumer choice and profitability. Now, with Cortex-QM, our innovative quality improvement simulation application, quality improvement teams have a powerful tool to develop effective strategies and measure performance trends.

 

Discover Our Free Webinars

Mile High Healthcare Analytics is the proud host of the MHHA Webinar Series. In these sessions, Richard Lieberman and occasional guest speakers from various parts of the industry discuss topics relevant in Medicare Advantage, Medicaid, and the Health Insurance Exchanges.

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