Analysis of your data organized into episodes of care offers a window into operational efficiencies, outcome improvements and potential savings that can be achieved when viewing data holistically. FH^® Episodes of Care Analytics examines three years of your organization’s claims data to identify discrete episodes and compare actual to expected costs based on risk-adjusted patient profiles. Once your claims are grouped into episodes, FAIR Health will develop a series of dashboards and analytic reports that present your cost and utilization in ways that can help you identify areas for improvement:

• Episode category—e.g., chronic, acute procedural, system-related failure;
• Distinct episode—e.g., diabetes, colonoscopy, knee replacement;
• Provider-related—analyses of practice patterns associated with specific physicians and facilities and identifying potentially avoidable complications (PACs); and
• Member-related—analyzes data at the member-specific level—including risk factors and comorbidities which can impact the costs of care.

Analytics and reports highlight best practices and areas of improvement that will help you to develop a roadmap to create efficiency, improve outcomes and recognize opportunities for savings. Specific uses include:

• Predicting costs based on patients’ conditions and risk profiles;
• Supporting network negotiations;
• Analyzing cost trends over time; and
• Developing detailed budgets for future episodes.

Visit who we serve for examples of how our episodes of care products can meet your needs.

The FH NPIC (National Private Insurance Claims) database includes information found on claim forms for billions of medical and dental services billed through private health insurance. Custom de-identified datasets can be extracted from the database to support cost and utilization studies. In addition, de-identified member IDs for millions of patients make it possible to track their treatment path over time and support longitudinal studies that follow patients by diagnosis, where they receive healthcare and other dimensions. Our data can support many types of studies, including:

• Tracking readmissions, courses of treatment, selection of venues of care and more;
• Following a de-identified patient’s treatment path and providers’ practice patterns over time;
• Measuring trends related to diseases and conditions;
• Conducting cost and utilization analyses; and
• Identifying variations in conditions and treatments in different populations, including such variables as age band, gender and geographic location.

Visit who we serve for examples of how our line-level claims data can meet your needs for research and commercial analysis.

The FAIR Health database, which is the foundation for our FH Benchmarks and other data products, also supports the creation of custom analytics designed to client specifications. The flexibility and breadth of our data enable selection of the precise combination of data elements required to support your one-of-a-kind analyses.

Custom products can be developed to reflect reorganization and/or re-aggregation of the underlying data. A sampling of FH Custom Analytics includes:

• Data aggregations based on differing geographic regions: custom community, state and urban/rural configurations;
• Charge and allowed benchmarks for specific procedure codes and ranges of codes;
• Services performed in specific settings for care (urgent care centers, emergency departments, home health, etc.), striated by year and by patient gender, age and diagnosis;
• Benchmarks for specific percentiles; and
• Provider specialty differentiation.

Visit who we serve for examples of how our custom analytics can meet your needs.

FAIR Health’s customized datasets provide you with data to conduct your own analyses. Or, you can select FH Dashboards, easy-to-use visualization and analytic tools that help you streamline your analyses and drill down through the data to reveal new insights, isolate essential elements and highlight your findings. Topics for dashboards we have created to date include specialty Rx, durable medical equipment (DME), dental services, emergency room treatment, evaluation and management (E&M) and place of service data.

This interactive presentation tool offers you:

• Point-and-click desktop access to reveal multiple layers of data. With the click of a mouse, view and compare cost and utilization data, including provider’s specialty; sort the data to view it by geographic location at the state, region or geozip level; striate results by patient age and gender; and view trending over time, procedure code, diagnosis code and/or associated category.
• Presentation options.
  • Your customized dashboard can present FAIR Health data alone, or compare it to your own data or an external source, such as Medicare fees.
  • You can apply any combination of a variety of filters to isolate data elements to refine your analyses.