Our Data IQ platform enables you to predict health cost, disease burden, and utilization for your population up to 12 months in advance using advanced, proven risk stratification and predictive modeling technologies developed at Johns Hopkins University and Health Cost IQ.
Intuitive, easy to use dashboards quickly identify utilization patterns and cost trends in your data, stratifying members and employer groups into distinct risk categories in the process along with displaying the utilization behavior and disease burden driving their risk profile.
With this information updated and readily available with each data refresh, you can act preemptively in so many ways, such as initiating targeted member and group interventions, setting appropriate premiums for your employer groups well ahead of renewals, and more.
Whether you are a large or small PEO looking to make sense of your claims and premium data, a broker seeking to establish yourself as a serious player in the market, or a medical management company looking to deliver the best value to your clients, the challenges are largely the same, and they tend to revolve around how best to make health data actionable and use it to drive decision-making.
The Health Data IQ platform was built from the ground up to address this serious deficiency. This highly customizable platform is easy to deploy and use, and we handle all the heavy data lifting for you. In fact, once we have a BAA signed with your payer or data vendor, most clients never have to lift a finger during implementation until their dashboards are deployed and ready for use.
Click on the appropriate tab below to learn more more and to find out how this powerful platform can transform your organizational decision making and tremendously enhance your bottom line.
According to studies published by the Journal of American Medical Association (JAMA) and others, it is estimated that 25% to 30% of all healthcare spending in the US can be categorized as “wasteful spending.” Within employer health plans, the picture is much more dire. According to Health Cost IQ’s analysis of health plan spending data of more than 1500 employers of various sizes operating in various market segments geographically distributed across the entire US, more than 50% of the total spend on healthcare by private employers can be categorized as wasteful or inefficient.
Our brand-new Opportunity Discovery module was built to address this serious deficiency. This module utilizes a series of smart algorithms (110 and counting) to mine medical and pharmacy data to uncover systemic and avoidable inefficiencies, wasteful spending, potential fraud, abuse, and unnecessary costs that exist within most health plans, enabling employers to identify and quantify – in precise dollar terms – opportunities for cost reduction and to take concrete actions to minimize those costs and prevent them from reoccurring.
The Opportunity Discovery module is ideal for plan design and formulary design and is typically deployed for ongoing, enterprise-wide cost containment initiatives. The module is subdivided into the following three categories:
The reports in this module shine a light on various types of costly inefficiencies. Algorithms analyze medical claims for avoidable, wasteful spending across different services such as Payment Accuracy, Clinical Lab Services, Durable Medical Equipment, Evaluation and Management Services, Administered Drugs and Immunizations, Imaging, High-Cost Providers, and more.
The drug cost opportunity reports provide findings in several key areas of drug utilization and prescription patterns. Inefficiencies frequently occur within formularies and within pharmacy spend as a whole in areas such as over-prescription of expensive brand name drugs, under-utilization of less-expensive generics, best-buy generics, generic therapeutic alternatives, and more.
The ER Utilization cost reports provide insights into emergent and non-emergent ER claims compared to total ER claims. All ER visits are analyzed and opportunities are presented for redirecting patients based on their presenting diagnoses to other, less expensive places of service such as Urgent Care, Physician Office, or Telemedicine, realizing significant cost savings in the process.
Analysis paralysis is a common symptom of data overload. It’s not that many folks don’t know what they are looking for. The problem is that it takes many steps and many clicks to get to the data they need, and then many more hours to make sense of the data once you find it.
HCQ simplifies that process by performing advanced risk stratification and predictive modeling processes on your data and presenting the results to you in a clean, easy to use interface, enabling you to get the information you need quickly, so you can spend your time on doing your work and making important decisions.
Below are just a few use cases coming out of the Health Data IQ platform:
Our Utilization Cost module utilizes sophisticated statistical modeling, based on the Johns Hopkins ACG System and the DataIQ predictive model to forecast costs across multiple risk categories, 12 months into the future. Individual members as well as disease clusters and employer groups are risk-adjusted and stratified into one of 5 high-level risk groupings, providing Meaningful insights into the pattern and flow of cost and utilization across populations and employer groups.
Our Disease Conditions module displays disease prevalence in the whole population, with the ability to drill down to entire chronic conditions, employer groups, and individual clinical profiles depending on the role of the user. Drill down to individual ZIP codes or cities is also available for policymakers.
Our Employee Utilization module provides stratification of risk, cost, and utilization patterns of employees and their dependents as well as for employer groups. The most frequently visited care locations for each group are highlighted (ER, urgent care center, hospital admissions, etc.). The same type of analysis is available by medical plans.
Our Emergency Room and Urgent Care module displays a Frequent Flier report showing the members or groups who are the heaviest users of these high-cost services, analyzing what days of the week they tend to utilize these services the most. Additional detail is also available, including their geographical locations and clinical profiles.
The Pharmacy Profiling module tracks all prescriptions that have been written; monitoring whether chronically ill patients fill their prescriptions on time, as required, or even have a prescription to treat their conditions. “Action reports” spotlighting individuals whose prescriptions have lapsed is available, valuable for follow-up by case managers. Insights about pharmacy costs, prescription patterns of individual providers and provider specialties, and drug utilization by members and groups can be easily called up with just a few clicks..
The Provider Profiling comprehensive risk profiles of providers across all chronic conditions, including average risk scores for each provider’s panel, cost, and clinical profiles. Tools are provided for efficient analyses and comparison of the risk and illness burden borne by individual providers across the entire population.
A Population Mapping application generates reporting for geo-access analytics and for geographical tracking of disease prevalence by a chronic condition, member demographics, prevalent health risks, and more. A highly customizable map to geographically track an unlimited number of metrics to ensure that organizations can better respond to changing demographics, provider access issues, member and group needs, and more.
The powerful Risk Trends module provides ongoing tracking for changes in the health status of members and risk profiles of employer groups as well as monitors new medical conditions that are occurring within the population. This module chronologically and graphically highlights trends along with all associated costs to aid in the detection and aversion of negative clinical and cost trends.
An Unusual Cases module monitors potentially high-use, high-cost individuals and groups who exhibit characteristics that may necessitate more proactive case management or intervention. It provides profiling of groups such as maternity patients, frail members, and members with unusual categories of diagnosis and recommends individuals and groups for closer monitoring and intervention by case managers and care coordinators.
The Stop Loss module consists of an administrative dashboard that utilizes a client-specified deductible amount (such as $500K) and deductible threshold (such as 50%) for a health plan to analyze individuals and groups that have met or exceeded the threshold that triggers individual or aggregate stop loss coverage. Deductible amount and threshold are adjustable on the fly by the user. Details such as family relationship, total claims amount, diagnoses, procedures, and medication cost are displayed for those that meet the criteria.
HCQ is led by an experienced team of healthcare, medical, and IT professionals with a combined experience of over 120 years.
The company was borne out of the founder's doctoral research into the enormous health costs associated with hospital treatment, and the lack of proportionally positive health outcomes that result from those high costs.
Mission
We create actionable insights to help organizations solve big healthcare challenges, empowering decision-makers to improve lives and reduce costs.
Vision
We intend to have a profound and positive impact on America’s healthcare system, improving the health of millions while significantly reducing the healthcare cost burden felt by employers of all sizes and organizations in the health sector.
Values
Clarity
We clearly identify each client’s unique goals and needs, then we apply our proprietary tools to transform data into clear, meaningful insights. We then help each client build clear step-by-step plans to improve lives & reduce costs
Accuracy
Our commitment to urgency will always be balanced by an equal respect for doing accurate work. We strive to get our clients to value much sooner than others can, but doing so meticulously and deliberately.
Value
We bring sophisticated technology to organizations that may think they cannot afford it and we offer “big vendor” solutions at accessible price points. We strive to turn masses of data into cogent stories that create tremendous value for our clients.
We are looking for individuals to join our team who are innovative, self-motivated and looking to help drive change in the healthcare industry. Whether working out of our main office in Chandler, AZ or remotely, you will enjoy working in a warm and inviting, small company atmosphere where your opinion is valued and your contributions make a real difference.
We offer a full range of benefits including full medical, dental, vision, life, a retirement plan, and more.
Check out our available positions today by visiting the link below:
Johns Hopkins University ACG® System
NYU Stern School of Business EFL Program
Newchip Global Accelerator Program
Employer Benefits Enrollment Solutions Provider
