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Managed Care

Healthy business decisions
A large task for the managed care organization is managing encounter data associated with delivering health care services in a way that empowers the business decision process.  This task is vital to several ‘players’ in the managed care organization.

Managed care administrators use consolidated encounter data, capitation fund data, and utilization data to help negotiate health care delivery contacts, manage organizational costs, and plan business growth.  Primary care physicians and business managers use the encounter data to measure business performance, examine service quality, and calculate utilization. Finance department personnel use encounter data, consolidated encounter data, and capitation fund data to report organizational business performance and ensure timely fund remittance.  Quality assurance and utilization department personnel use encounter data to monitor service delivery trends and patterns.
Healthy business decisions

Evaluating the business

Visualize and analyze

Communicate important findings

Pronouncing a healthy business

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