Predict the impact of regulations and minimize future disruption while improving member satisfaction and engagement
Advisory Services
Data-driven management services that optimize data and analytics capabilities and organizational infrastructure to support companies’ business objectives and goals.
Data and Management Capabilities
Partner with an expert team to develop data and management capabilities to support business priorities and achieve target outcomes.
Holistic Evaluation
Apply a holistic approach to evaluate an organization enterprise-wide, using data from disparate sources, to determine capabilities objectively.
Gap Identification
Utilize robust data and analytics capabilities to uncover gaps in clinical performance, operations and care delivery.
Organizational Needs
Gray Matter Analytics' Advisory Services enable healthcare executives to:
Optimize outcomes and operational efficiency
Payors need to use data to provide insights toward better provider network and member management, influence behaviors and increase member satisfaction and engagement.
Manage regulatory uncertainty
With the dynamic nature of healthcare regulatory controls, payors need to be able to predict the impact of new regulations and minimize future disruption operationally and financially.
Leverage data and analytics to support business decisions
Payors need to optimize their data and analytics capabilities to strengthen member engagement and satisfaction, maximize financial return and improve outcomes.
CoreTechs® Analytics Payor Solutions
Provider Engagement
Payer/Provider Collaboration Metrics | Population Health-based Segmentation | ACO performance | MACRA Metrics | Provider Scorecards/Dashboard
Networks Management
High-Performance Networks | Tiered Network Metrics | Provider Information Management | Credentialing/Contracting Metrics
Medical Cost & Pharmacy Management
Medical Policy Benchmarking | UM Prior Authorization ROI | Medical Cost Dashboards | CM Program ROI | Formulary Design | Medication Adherence
Payment Integrity
Anomaly Detection | Adjustments & Penalty Prediction | Adjudication Decision Support | Financial Accuracy | FWA Identification | Appeals and Grievances | Home/Host Optimization
Quality
Stars Effectiveness and Optimization | HEDIS Effectiveness and Optimization | QBP Tracking
Operations
Claims Analytical Reporting | “Next Best Action” Prediction – Member/Provider Services | Enrollment Tracking | Retro-cancellations | Eligibility Verification | COB, Subrogation
Products & Benefits Design
Performance Metrics | Product Optimization | Product Portfolio Metrics | Value-Based Products | Pricing Metrics | “Quote to Card” Tracking
Consumer & Group
Consumer/Member Segmentation | Self-Insured Group Dashboards | Commercial Client Dashboards
Advisory Services
Data and Analytics Strategy
The goal is to transform the way organizations conduct business, geared toward delivering significant performance gains. We help organizations develop a robust and insights-driven data and analytics strategy that will ultimately become a major competitive differentiator.
Analytics Organizational Models Design and Implementation
We developed our own organizational models and framework to help healthcare organizations optimize analytics throughout the organization. They help our clients determine how best to organize analytics efforts within the organization and what core analytics processes the organization must support.
Master Data Management Strategy
We help healthcare organizations simplify resource descriptions and provides vocabularies to link contexts by helping them develop an effective Metadata Strategy and unlock the value of their data.
Data and Analytics Architecture
The challenge is to bring the two paradigms together: unified information management and rapid-cycle analytics. We work with healthcare organizations to build or reinforce their data and analytics architecture as this expertise is not usually present in their existing resources.
Data Governance Strategy and Implementation
We partner with healthcare organizations to help them not only develop a triple-aim focused data governance strategy, but also to implement this strategy with minimal disruption to existing operations.
Data and Analytics Maturity Assessment
We partner with healthcare organizations to help them not only develop a triple-aim focused data governance strategy, but also to implement this strategy with minimal disruption to existing operations.