Forecast Expound Pursue

Comprehensive Data Driven Solutions

BIG DATA

Empowering Healthier Populations and Maximizing Bottom Line with Advanced Risk Profiling and Predictive Modeling Insights

Population Health

Boost health outcomes and financial efficiency with our sophisticated risk profiling and predictive modeling insights.

The SiOHP platform provides advanced risk profiling and predictive modeling insights to aid healthcare organizations, such as PEOs, medical management companies, or employers, in transforming health data into actionable insights. This results in enhanced decision-making processes and boosts bottom-line outcomes. This highly customizable platform streamlines the complex process of health data analysis, enabling clients to anticipate health risks, control costs, and enhance overall health outcomes. The in-depth analytics and robust reporting capabilities of the SiOHP platform deliver insights into premiums, medical, and pharmacy cost trends, empowering organizations to make informed management decisions and proactively mitigate risks.

Medical Opportunity Discovery

We use advanced algorithms to pinpoint wasteful spending in medical claims across various services, promoting financial efficiency.

This module takes advantage of powerful algorithms to meticulously analyze medical claims, aiming to highlight areas of potential wasteful spending within various services. By focusing on aspects such as Payment Accuracy, Clinical Lab Services, Durable Medical Equipment, Evaluation and Management Services, Administered Drugs and Immunizations, Imaging, High-Cost Providers, and more, our module can provide comprehensive insights, ultimately paving the way for more streamlined operations and significant financial savings.

 

Pharmacy Opportunity Discovery

Uncover potential cost savings in drug utilization and prescription patterns by highlighting inefficiencies in the use of brand-name and generic drugs.

This feature delves into the intricate world of drug utilization and prescription patterns, providing detailed reports on potential inefficiencies within formularies and pharmacy spend as a whole. Whether it’s the over-prescription of expensive brand-name drugs or the under-utilization of cost-effective generics, our Pharmacy Opportunity Discovery can illuminate opportunities for cost reduction, promoting more financially sustainable healthcare practices.

ER Opportunity Discovery

By analyzing ER visits, this module identifies opportunities for cost-effective patient redirection based on diagnoses, aiding in substantial cost savings.

Our ER Utilization cost reports provide an in-depth look into ER claims, comparing emergent and non-emergent instances to total ER claims. All ER visits are systematically analyzed with the goal of identifying opportunities for more efficient patient redirection based on their presenting diagnoses. By suggesting alternatives such as Urgent Care, Physician Offices, or Telemedicine, we can provide pathways for significant cost savings without compromising patient care.

Why Work With Us?

Fast Accurate Results…

On average, our clients experience a substantial $2.5M reduction in health plan expenditures in their initial year with us. This impressive saving is achieved through our diligent approach in mitigating risks, streamlining inefficiencies, curbing wasteful expenditures, and combating fraudulent activities.

Comprehensive Health Strategy

We seamlessly integrate several health strategies into a unified suite of products, all designed to enrich individuals’ health journeys and positively impact outcomes.

Our unique predictive care approach employs rigorous analysis of patient health data, enabling us to foresee potential risks and provide personalized, effective care management services. We harness a spectrum of intervention methods, including extensive physician support, remote nursing, and vigilant data monitoring to foster improved health and reduced risk. Our application of predictive modeling through AI allows us to stratify patient populations by risk, identify care gaps, and unveil opportunities for timely intervention.

Consumer Health Interface

Our user-friendly dashboard provides detailed risk analytics, powered by AI to pinpoint individuals requiring urgent intervention. Our proprietary SiOHP system provides reliable tracking, management, and reporting. Member engagement is prioritized through personalized, data-driven interactions.

Care Gap Resolution

We aim for perfect alignment with your primary care plan, including detailed explanations of lab results and the arrangement of care gap closure visits. We ensure regular outreach and targeted mailings for consistent patient engagement.

Medication Coordination

We ensure a holistic view of medication management, addressing potential drug interactions and unnecessary duplicate therapies.

Plan Coordination & Navigation

We provide comprehensive plan design support, from reference-based pricing to specialized provider networks. Our system facilitates the integration of additional care initiatives (such as telemedicine, on-site or near-site clinics, EAP, diabetes supplies) with wellness and plan carve-outs.

Lifestyle Coaching

We offer an opt-in coaching program focusing on healthy eating, weight loss, fitness, stress management, and tobacco cessation.

 

Primary Care Support

Our system ensures constant communication with your primary care provider, updating them on any patient interaction outside clinical visits. We provide patient-focused care plan support, including detailed explanations of lab results and their potential health impact.

Care Management

Our nursing team provides follow-up communication and patient education. We manage health assessments and coordinate medical management services with social determinants of health.

Personal Portal

Our personal online health record tracks your medical and prescription claims, doctors’ appointments, reminders, and upcoming screenings and tests.

Virtual Nursing and Outreach Programs

We offer bespoke programs designed to address specific client needs and create immediate impact. Our secure and HIPAA compliant modes of communication include text, email, and calls. Our targeted campaigns leverage the SiOHP Health Platform or the client’s existing population health analytics for maximum impact.

Our technology and virtual nursing programs are meticulously tracked, with comprehensive reports on both utilization and outcomes.

Our Results

Your Bottom Line

Medical Management Services

Our thorough management strategies cater to catastrophic injuries, illnesses, and chronic care needs. Our case managers conduct comprehensive reviews of referred individuals to formulate mutually beneficial management plans, ensuring complete patient and family support throughout the decision-making process. We offer real-time online reporting capabilities for effective communication with health plans concerning case activity and care coordination.

Our large case management service covers multiple specialties including medical, surgical, mental and behavioral health, chemical dependency, and high-risk maternity.

We pride ourselves on an impressive ROI of 5:1.

 

Utilization Management

Our URAC accredited utilization review program determines the medical appropriateness of treatments, procedures, admissions, levels of care, settings, and lengths of stay, and assesses discharge needs.

Our Results In The First Year

Increase in care gap closure 21
Increase in pharmacy interactions closure 46

Quick Contact

Comprehensive Dashboards and Reports

Featuring intuitive design and clear visuals, our comprehensive dashboards and reports are effortlessly easy to use and understand, enabling you to make data-driven decisions with confidence.