Patient & Member Metrics

Healthcare Organizations are focused on creating a more personalized and valuable experience for their members/patients to engage them in the management of their care with the goals of increasing satisfaction, reducing costs and improving outcomes.
To do this effectively, your organization needs a holistic view of what is happening at the member/patient level from existing medical care needs to predictive indicators of future needs.
The Clinigence Health Member/Patient Metrics solution provides a holistic view of an individual member/patient to:
- Access current member/patient cost and utilization metrics by condition
- Determine gaps in care based on Commercial CQM criteria
- Review predictive indicators of future costs and use of services
- Drill into costs by provider, place of service, type/specialty, diagnoses, procedure and hospital revenue code
- Identify top prescribers for each member/patient including top drug classes by cost, generic vs. brand and top drugs by cost