A s health plans face simultaneous pressures to improve quality and member experience, reduce costs, and meet regulatory requirements, a broad-based range of initiatives is required. These range from collaborating more closely with providers in the form of business incentives and technology integration to more closely engaging with members and analyzing, and even predicting, their satisfaction. And in a post-ACA environment, health plans are working through models to quickly understand the health and risk of new members in order to assign correct RAF (Risk Adjustment Factor) scores and ensure that care plans are quickly put into place for high risk members.
SPH Analytics has been working with health plans for 35 years and has a comprehensive set of quality, cost, and experience measurement and analysis solutions to help health plans thrive in the ever-evolving business and regulatory climate. Our solutions help health plans to: