Population Value™ | Financial Solutions
SPH’s Population Value™ | Financial Analytics drives success in value-based contracts. Population Value taps into the power of big data to gain a comprehensive view of your population and financial situation. The solution provides an unmatched visibility into your ACO operations for meaningful advances in performance improvement and personalized patient intervention. Population Value ingests claims data to monitor expenditure trends, understand leakage, predict future utilization, and stratify the population. Both cost and clinical data are used to segment the population into chronic condition groups, high risk, and high cost segments. Population Value delivers insight through:
- Commercial and government (Medicare) ACO contracts managed in a single dashboard
- Financial and utilization metrics across the population with ability to drill down to patient-level or claim-level details
- Flexible, self-service analytics with custom reporting and visualizations
- Fast implementation within 2-4 weeks with drag and drop CCLF and commercial claims files
Cost Management
The Population Value application analyzes and categorizes claims data to monitor per member per month (PMPM) expenditures to support cost management for ACO populations. The tool identifies in- and out-of-network expenditures (leakage), as well as identifies trends in expenditure categories, such as inpatient, physician, DME, imaging, etc. Drill down capabilities at the practice, provider and patient level enable focused efforts on cost drivers and overall PMPM performance. The solution leverages claims data so ACOs can improve their financial performance against benchmark goals and targets.
Utilization Metrics
Financial Risk
