Business intelligence solutions
Pareto Intelligence supports healthcare plans and providers with revenue, cost, quality, and risk-adjusted payment models:
- Pareto Sentinel: Utilizes clinical and claims administrative data to identify and prioritize gaps in quality and risk score documentation.
Pareto Perform: Defines trends in risk adjustment performance, evaluates program effectiveness, and assesses financial implications.
Pareto Engage: Targets points of failure in the submission of quality and risk-adjusted conditions with a focus on prospective and point-of-care interventions and supporting targeted retrospective traditional solutions.
Pareto Economics: Allows stakeholders to stratify risk-adjusted membership based on post-risk-adjusted profitability to support data-driven marketing, product designs, and tailored care and network management solutions.
HealthScape Advisors' Cost Accounting Scenario Tool, CAST, provides healthcare clients the ability to create and compare multiple cost allocation scenarios using recent cost center and allocation based data in a secure test environment.
CAST allows our clients to extensively evaluate cost allocation approaches which could improve recovery in a compliant manner, while also evaluating simplifications to cost allocation approaches which reduce audit and execution risks in the future.
HealthScape Advisors' COB Advantage solution provides Health Plans with a web-based survey application that seamlessly collects information from employer groups, as required by Medicare Secondary Payer (MSP) and Medical Loss Ratio (MLR) regulations. This electronic tool significantly reduces administrative effort/cost for Health Plans and employer groups, as well as helps to mitigate regulatory compliance risk.