With the move towards value-based care, risk and profit sharing models, acute and post-acute providers have strong incentives to identify opportunities to reduce total cost of care, and manage resources better while improving patient outcomes. CapsicoHealth enables deep insights for financial specialists and program managers at providers, ACOs and Payors by analyzing billions of data points around population level costs, utilization and quality. CapsicoHealth drives this through advanced technology that can analyze thousands of rules in real-time across vast data sets, and spot at-risk populations that need timely care and improve pathways for outcomes improvement.
For providers to embrace value based care and payments they have to identify areas where total cost of care can be reduced across sub-populations. In addition, providers have to minimize the negative outcomes over sub-populations (e.g. hip/knee patients with complications). Poor or limited coordination amongst providers with manual operational processes and sharing can lead to unplanned hospitalizations and ER visits and non-adherence to care pathways. CapsicoHealth offers episode level tools for case and care managers to rapidly track at-risk patients, share information across provider groups and operate efficiently on care and support.
CapsicoHealth's platform provides cloud based tools for providers to manage risk contracts, identify opportunities to reduce cost variation (e.g. hip and knee surgeries) and drive interventions. Recent studies have shown that 35% of patients do not adhere or follow their treatment plans and health goals. CapsicoHealth's platform can pin point high risk (outliers) groups that are likely to have unplanned hospitalizations or ER visits, and lead to high variation in care and costs.