ClaimsDX Post-Acute

The Skein Health ClaimsDx Post-Acute product is a fully integrated solution that allows you to view post-acute facility claims data in order to effectively intervene to improve performance, patient outcomes, and the bottom line. Consisting of several modules, and using the same intuitive “drill-down” interface as ClaimsDX Inpatient, ClaimsDX Post-Acute allows staff at all levels see and understand drivers of utilization management performance — from high end KPIs down to individual member claims. If the inability to gather and categorize data into meaningful, actionable classifications is familiar to your organization, and you are looking for a solution that works on day one, contact us! We’ll be happy to discuss your needs and provide you with a demonstration of how we can make a difference for you and your members.

 

SNF Module

Skilled nursing facilities are a key step in the care journey of our sicker members.  Can you tell at a glance how referral patterns are going?  What about SNF readmissions or cost of care?  Often network strategy is every bit as important as managing utilization.  The SNF module will help you manage both.

  • Intended for use by concurrent review/post-acute utilization staff, medical directors, and network operations.

  • For your custom cohort, can lead to answers to these types of questions:

    • What are the worst readmitting SNFs in my market?  What are the best?

    • Based on utilization, cost, quality, and network availability, which SNFs can be pulled out of network?

LTAC Module

Long term acute care facility utilization can go from a rare to a daily challenge depending on your geography and benefit design.  For those who have this challenge, the lack of good reporting can make a bad situation worse.  The ClaimsDX Post-Acute LTAC module brings the same high standard for insights you expect from the Skein Health ClaimsDx platform into the LTAC space.

  • Intended for use by concurrent review leaders, network operations, and Medical Directors.

  • For your custom cohort, can lead to answers to these types of questions:

    • Who are my key admitters and why?

    • What am I actually paying for this service and how do providers compare?

inpatient rehabilitation module

For some indications, inpatient rehab is a crucial, evidence based step in your members’ recovery.  For others, it represents a variance with no support in the medical literature.  In all cases, it is resource intensive.  Understanding exactly how this service is being consumed is mandatory and it requires a tool that will answer the key questions.  The Inpatient Rehabilitation Module is the right tool for the job.

  • Intended for use by concurrent review leaders, network operations, and Medical Directors.

  • For your custom cohort, can lead to answers to these types of questions:

    • Are the drivers of utilization the diagnoses you would expect?  Is that true for all providers?

    • What are the differences in the cost for my providers?  What about readmission rate?

You need an end-to-end view into post-acute claims, with data presented in a way that makes sense along benchmarking designed specifically to help you answer these and many other questions.  You need Skein Health ClaimsDx Post-Acute.  It delivers real value, not just charts, out of the box. Contact us to learn more about how we can help, or to arrange a demo.