SCIO Health Analytics’ acquisition of Clear Vision Information Systems brings complementary analytics capabilities to aid providers and insurers serving chronically ill populations, while also generating additional revenue.
Supporting improved population health management is the rationale for the deal, says Rose Higgins, president of North American operations at SCIO. Her company, which paid an undisclosed amount for Clear Vision, specializes in predictive and prescriptive analytics focusing on reimbursement and care optimization. Clear Vision specializes in risk adjustment and quality metrics analytics that assess the level of care quality, including closing gaps in treatment.
Higgins notes that providers are increasingly being contractually incentivized by insurers to achieve better outcomes, which increases their reimbursement while lowering costs for insurers. Clear Vision offers risk adjustment factors that are specific to the Medicare, Managed Medicaid and health insurance exchange markets; they indicate the overall clinical and financial risk of a patient. Scoring methodologies show providers and payers where the sickest patients are so they can appropriately focus resources.
Clear Vision’s “risk score gaps” capability also helps identify patients who have changed providers or insurers. Because of coding gaps, a new provider or insurer for a patient may not initially know that the patient has COPD or other major chronic conditions. “We now can include this information in models to predict where these conditions are occurring,” Higgins says. “It adds additional value to the scoring models and broadens the view.”
Clear Vision also supports comparisons of physicians’ approaches to treatment. For example, a physician may be doing a good job, but if he or she looks at another approach as well, it could generate additional revenue while improving clinical practices, Higgins explains.
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