Solutions Episodes of Care

FH®
Episodes of Care Analytics

FAIR Health will process three years of your claims data to create episodes of care bundles specific to your organization. Dashboards and analytic reports are designed to present your results as actionable support for strategic decision making.

Detailed Analysis of Your Claims Bundled as Episodes of Care

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—analyses at the member-specific level—including risk factors and comorbidities that can impact the costs of care.

Analytics and reports highlight best practices and areas of improvement that will help you to develop a road map 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.