Best-in-Class Reporting & Analytics

USPM Health Intelligence

USPM Health Intelligence turns data into knowledge, and actionable intelligence. We integrate thousands of data points from The Preventive Plan, medical claims, pharmacy claims, lab data, and health assessment data into a centralized person-centric data model known as our Health Intelligence Platform.

The platform includes data consumption processes, analytics, outcomes, and intelligence in support of our population health and disease management programs. The USPM Health Intelligence Platform is an open, flexible architecture that handles the import of eligibility, medical, pharmacy, biometrics, and other data from a variety of sources into a centralized repository.

The centralized repository is used in the following capacities:

  1. Population Opportunity Analysis - Identifies the prevalence rates, costs and utilization, and risk of chronic diseases across the client’s population; it includes impact extrapolation and risk modeling which presents potential opportunities for risk reduction, and costs savings through implementation of wellness and disease management programs
  2. Eligibility management processes - Ongoing processes to manage participant eligibility for program participation, allowing clinicians to review eligibility, claims, and utilization history
  3. Ongoing disease identification and risk stratification processes - Used to identify potential participants eligible for USPM services
  4. Outcomes reporting - Quarterly and annual reporting of outcomes including PMPY costs, utilization, gaps in care, risk reduction, participation and more

Care Management Analytics

With our Care Management services, we run a disease/condition identification process to identify participants with certain diseases or conditions that would benefit from our programs. The disease/condition identification process integrates the medical and pharmacy claims isolating certain diagnosis codes, procedures, or medications that would indicate a person has a chronic condition such as diabetes, heart failure, asthma, CAD, etc. We take this actionable intelligence and proactively conduct outreach to individuals to address these chronic conditions that escalate health care costs.

Program Outcomes and Analytics

The other end of the process is our outcomes and analytics. We provide the in-depth outcomes and analytics that are used to tell the story of what we do – how we reduce risks, increase compliance with preventive screenings, reduce in-patient and ER visits, show the return on investment, and in general, show how we improve the overall health, and quality of life for our members. 

Our Health Intelligence services are done 100% in house. There is zero outsourcing of this service. The entire Health Intelligence Platform was developed in-house and all outcomes and analytics are provided by our Health Intelligence team. We continue to build new rules and algorithms every day as our products and our clients’ needs evolve.

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