SCIO® offers a suite of solutions that help payers and providers manage their costs and improve outcomes in the areas such as population health, claims payment, health cost and risk adjustment, consumer engagement, quality measurement, network management and commercial effectiveness. We strive to deliver flexible solutions that drive measurable change and outcomes improvement through care, network and reimbursement optimization as well as commercial effectiveness.
Our Suite of Solutions
Through advanced analytics, SCIO® uncovers the opportunities that lead to lower costs and healthier outcomes – thereby enabling healthcare organizations to realize the true potential of value-based care. Key to success in this endeavor is the ability to deliver actionable knowledge to identify the highest opportunities for health improvements and cost avoidance. SCIO’s analytics transforms data into the intelligence that drives efficient and effective care using relevant, predictive, and actionable insights.
We provide the following solutions under Care Optimization:
- - Population Health Management
- - Quality Measures
Healthcare organizations benefit from standardizing care around their top performers. It’s difficult to accurately measure provider efficiency, making like-for-like comparisons between providers impossible. To optimize payments, organizations also need to keep patients within their network and proactively prevent leakage. To address this need, SCIO’s network optimization capabilities drive care quality and utilization improvement by measuring provider and network efficiency and performance.
For Network Optimization, we provide the following solutions:
- - Provider Performance and Efficiency
- - Network Management
SCIO® supports comprehensive, holistic reimbursement initiatives that help payers and providers control costs, reduce overall health claim expenditures and optimize revenue opportunities while improving care quality. Our solutions provide the sophisticated insights required to manage risk, contain costs and prevent payment errors that occur due to the complexity of healthcare reimbursement overall. More specifically, SCIO® leverages data analytics to produce actionable insights at every touchpoint along the payment continuum from the prevention of claims errors; to the remediation of errors pre-payment; to claims corrections post-payment.
Our solutions for Reimbursement Optimization include:
- - Payment Integrity
- - Risk Adjustment and Compliance
- - Quality Measurement
The SCIOClarity line of solutions is a comprehensive suite of analytics and services that helps health plans and providers identify and address gaps in their risk adjustment and quality programs. The SCIOClarity platform generates actionable suspect lists of members with documentation gaps and our supplemental services allow clients to outsource retrospective (e.g. chart review) and/or prospective (e.g. member outreach) gap closure tactics. Through the use of these offerings, clients ensure accurate reimbursement in risk-adjustable lines of business and high performance in HEDIS, Stars, and Calif. P4P quality measures.
Maximizing the value of clients’ commercial data
With SCIO’s Intelligent Data solutions, we bring clients’ fragmented product, market and patient data under control so their commercial teams can think globally and act locally. SCIO’s innovative and cost effective data integration and reporting solutions are designed to integrate and manage complex data from a variety of sources and to give business users access to the personalized insights they need – whenever and wherever they need it.
Our SCIOIntelligence platform options include highly customized solutions for larger markets and a more standardized version for smaller markets. Via SCIOHub, users have easy access to intelligent data and essential business insights delivered through a visionary platform designed to connect, engage and inspire client commercial teams to work smarter, together.
Driving informed decisions across our clients’ organization
Powered by SCIOXpert, we deliver meaningful, personalized insights on targeted healthcare providers, patient populations or commercial activities, helping them compete and succeed in a changing life sciences market. We leverage our deep industry domain, technical and analytics expertise to pinpoint precise recommendations, prescribe actions and operationalize insights.
From C-suite to in-field users, our advanced analytics tools and capabilities are used to enhance sales effectiveness, measure marketing ROI, ensure launch success, pursue market expansion opportunities, and develop managed markets strategies.