FEATURES ANALYTICS SCIENCE – THE UNIVERSE Utilizes raw data and processes it through vigorous analytical programs to screen for those claims that vary.

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Presentation transcript:

FEATURES

ANALYTICS SCIENCE – THE UNIVERSE Utilizes raw data and processes it through vigorous analytical programs to screen for those claims that vary from norms. ProData Analytics Engine Projections & Forecasts Medical & Utilization Oversight Clinical Oversight Quality Gap Analyses Financial Analyses Compliance Testing

ANALYTICS SCIENCE – A MANAGEMENT APPROACH

ANALYTICS SCIENCE – PROBLEM SOLVING APPROACH

Top Prescribers Top Pharmacies Top Patients Key: PMPM = Per-Member-Per-Month Key: PMPM = Per-Member-Per-Month

ANALYTICS SCIENCE – PROBLEM SOLVING APPROACH Physician Office Visits Hospital Visits ER Visits Key: PMPM = Per-Member-Per-Month Key: PMPM = Per-Member-Per-Month

ANALYTICS SCIENCE – PROBLEM SOLVING APPROACH Our easy to read reports identify potential issues and weigh out the key concerns, which provides information to make informed decisions and/or to follow our recommendations. Diagnoses are provided – Collected from Medical Claims. Diagnoses are provided – Collected from Medical Claims. Concerns provides a reason why this patient was flagged for our reporting. Recommendations are Provided as a courtesy. Recommendations are Provided as a courtesy.

ANALYTICS SCIENCE – PROBLEM SOLVING APPROACH ProData Analytics and Pro Pharma Pharmaceutical Consultants, Inc. assists Clients and their Providers in making clinical and financial decisions with expert management tools which increase quality of care, and decrease costs.

ANALYTICS SCIENCE – GUIDED HELP Executive Summaries DiagnosticsNavigation Help / FAQs

Integrated Data MedicalPharmacyLaboratory How Does It Work? Data is received from Health Plans, Pharmacy Benefit Managers (PBMs), and Labs. This data is screened against benefit files. Analyses are provided so that the Clients can filter results according to their individual needs.

HEALTHCARE ANALYTICS – AN INTEGRATED APPROACH TO MANAGEMENT Executive Summary Annual Trends Lines of Business Comparisons Geographical Comparisons Population Management Pharmacy Experience Financial Clinical CMR / MTM UtilizationSpecialty Medical Encounters DiagnosesProcedures Location of Service Best-in-Class How much did we spend this past month, Fiscal Year, YTD? What was the impact of our prescribing patterns? What impact did our patients experience based on the Location of Service, Diagnosis, or Procedure?

EXECUTIVE VIEW Executive Summary Annual Trends Lines of Business Comparisons Geographical Comparisons Population Management Pharmacy Experience Financial Clinical CMR / MTM UtilizationSpecialty Medical Encounters DiagnosesProcedures Location of Service Best-in-Class Annual Trends Complete Fiscal Year or Year-To-Date Spending Line of Business Comparison Spending Filtered Based on each plan’s Benefit Design Geographical Comparisons Complete Spending Based on Geographical Location

MEDICAL / UTILIZATION MANAGEMENT VIEW Executive Summary Annual Trends Lines of Business Comparisons Geographical Comparisons Population Management Pharmacy Experience Financial Clinical CMR / MTM UtilizationSpecialty Medical Encounters DiagnosesProcedures Location of Service Best-in-Class We provide detailed analyses from Medical Data: Financial Impact Financial Projections Utilization Variance Quality Variance Clinical Gaps Our data driven analyses provides plan administrators with actionable business intelligence by which costs can be lowered and outcomes improved.

PHARMACY VIEW Month to Month Analysis Pharmacy Financials Invoice Screening Accounts payable functions Financial Spending w/ Metric Filtering Benefit Costs Pharmacy Financials Financial Spending based on Benefit Plan Design Geographical Costs Pharmacy Financials Financial Spending based on Geographical Location Age/Gender Summary Pharmacy Financials Financial Spending filtered by Age/Gender descriptions Executive Summary Annual Trends Lines of Business Comparisons Geographical Comparisons Population Management Pharmacy Experience Financial Clinical CMR / MTM UtilizationSpecialty Medical Encounters DiagnosesProcedures Location of Service Best-in-Class

COMMUNICATION Completed analyses are placed on a secure Cloud, where they are available to Clients on demand.

EXPERT GUIDANCE Pro Pharma has over 29 years of providing consulting expertise to assist and guide Clients through all analyses, illustrating the most important findings in the data to provide information to make informed operational decisions. ProData Analytics is powered by, and works closely with Pro Pharma Pharmaceutical Consultants, Inc. for expert guidance to better explain results of analyses and provide perspective.

Analytics should be available anywhere, on-demand Healthcare Analytics for Management On Demand Results Oriented Expert Advice TO SUMMARIZE… Within the limitations of the data Flexible to meet the needs of executive and clinical management.