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How to embrace the move to value-based care

Advanced health analytics solutions transform uncertain areas into valuable opportunities to reduce costs, boost performance, and enhance patient outcomes.

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Innovations in population health management

~$42B

Roughly $42 billion prospectively risk-adjusted

Roughly $42 billion in managed care premiums are prospectively risk-adjusted using Solventum™ Clinical Risk Groups (CRGs) annually.

Like maths, medicine is a science. Unlike maths, with medicine, problems don’t have one correct answer. Variations from case to case make it difficult to apply uniform treatment. Yet healthcare systems are challenged to efficiently serve every stakeholder, provide appropriate care to each patient, and charge accordingly.

This is where our proprietary patient classification methodologies and grouper applications bring order to what might otherwise be chaos. By stratifying patients based on risk, clinical characteristics, and other metrics, these groundbreaking solutions replace the grey areas with a common language that healthcare systems, payers, providers, and regulatory agents can share.

They can also energise your entire enterprise, and multiply your ability to contain costs, enhance facility performance, and significantly improve population health.

Which is the kind of maths both medicine and healthcare can appreciate.

Drive your organisation’s shift to value-based care

Whether for inpatient and outpatient populations, grouping applications enable better cost control, quality improvement, performance measurement, and data-driven decision-making.

Improve population health outcomes and measure risk adjustment

Actionable analytics and risk adjustment data simplify provider performance comparisons and make it easier to set up accurate payment models, implement timely interventions and make more informed choices.

Enhance workflows via accurate data and real-time reporting

Disparate teams can collaborate smoothly to pinpoint gaps and address them, for more accurate documentation, enhanced financial benefits, quality scores and more.

Predict and verify payment and reimbursement

Reliably forecast healthcare costs and validate accurate coding, billing and reimbursement amounts.

Help identify and track trending social determinants of health (SDoH) and health-related social needs (HRSN)

Our software detects relevant SDoH/HRSN data to help you create targeted interventions, allocate resources more efficiently, improve care quality, contain costs and promote greater health equity.

Measure facility performance with analytics and reporting

Get the granular details you need to optimise resource management, compliance, risk management, predictive analytics, quality of care and more, and identify every opportunity for improvement.

Egyptian Health: Strengthening care coordination for at-risk kids

On a mission to enhance quality and cut costs, Illinois' Egyptian Health Department embarked on a project to screen 11,000 Medicaid and/or CHIP recipients through phone and in-person interviews — but soon discovered that this approach didn’t provide the complete picture. However, with Clinical Risk Groups (CRGs), the organisation was able to validate complexities, meet Alternate Payment Method (APM) performance measures, and uncover risk profiles that might have otherwise been missed, thereby identifying at-risk clients.

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51%

A 51% reduction in potentially preventable complications by utilizing Solventum™ Potentially Preventable Complications (PPCs) Classification System, in an assessment from Maryland Health Servicesopens in a new tab.

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32 states 
32 states use one or more proprietary methodologies for payment, reporting, risk adjustment or quality measurement.
 

Much more than an ounce of prevention

No one can predict the future. But technology can help forecast potentially preventable medical events, offering a chance to examine data more closely — and intervene to improve patient safety. Explore our proven solutions.

Improve quality of outpatient care while controlling costs

Solventum™ Ambulatory Potentially Preventable Complications (AM-PPCs) Grouping Software

Solventum AM-PPCs identify potentially preventable complications (PPCs) that occur following elective ambulatory procedure encounters using sophisticated grouping logic. The software allows you to closely examine procedure encounters and clinically related complications by specific procedure, condition, service line, provider, and facility, providing insight into incentives and interventions that can help improve patient safety. Solventum AM-PPCs software is incorporated in the analysis of U.S. News & World Report’s 2023–2024 Best Hospitals Specialty rankings.

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