August 8, 2017

How Artemis is Working with Hospitals to Address their Data Challenges

U.S. hospitals are struggling. Between rising healthcare costs, fewer inpatient beds, physician shortages, mergers and acquisitions, rural hospital closings, and value-based compensation models, many are looking for ways to trim waste and maintain quality care. While 58.5% of hospitals are non-profits, they still need to operate in the black and find solutions to the skyrocketing cost of doing business.

Just like any large employer, hospitals are also interested in attracting and retaining talented employees. As Forbes recently reported, the aging population and growth in the U.S. is outpacing medical school graduation rates. Hospital systems need to offer great benefits at a great price point in order to recruit physicians, especially those practicing as primary care doctors.

Hospital employees are also hospital customers. Their benefit plans often allow staffers to receive care at their facility for deeply discounted rates, including pharmacy benefits. However, many hospital employers report a phenomenon known as “leakage.” Leakage has two potential meanings:

  1. When a doctor refers a patient to another doctor outside of the hospital system
  2. When a hospital employee seeks care outside of the hospital system

Both of these scenarios keep hospital administrators up at night. They’re losing potential revenue and patients due to the recommendations of their own staff. Plus, they’re paying more (as are their employees) for medical costs.

Artemis Health is finding more and more hospitals are interested in optimizing their benefits using data. They’re seeking transparency tools, easy data analysis, and the means to find waste in their spending. While most of the hospitals we talk to are using other means to analyze patient data, many are looking to Artemis to track employee benefits data. Here’s what we can do for them:

We can provide benchmarking insights.

Artemis Health uses a large, nationwide dataset to give employers insight into how their population stacks up against others. Employers look at risk scores, common services, regional trends, and pricing data to find out if they’re paying more than others, if their members are receiving good care, or if they need to address gaps in care. Hospitals can use this same data not only to find out how their employees are doing, but also to see how they stack up against competitors.

For example, a hospital using Artemis could find out if they’re competitive on pricing for certain procedures compared to other hospital systems in their region. They could compare admission rates, value, and service to find out how they’re doing.

We can compare physician performance.

Using de-identified data of employee health claims, hospitals could look at the performance of doctors within their system, just as employers do. Artemis can provide insight into how many prescriptions a given doctor is writing, how many admissions or return visits, or even which providers are referring patients to out-of-network providers. This could give hospitals the answers they need to address leakage or find ways to incentivize doctors.

It could also help find fraud or poor quality care. One employer using Artemis discovered that one in-network chiropractor was charging all their employees as out-of-network patients. This is just one example of how access to data can help employers find wasted spending.

We can work across legacy IT systems.

Health system mergers and acquisitions are so hot right now that Healthcare Finance News is keeping a running tally in a slideshow—and that’s just the most notable mergers. When systems merge, they’re dealing with two IT systems that often don’t “talk” to each other. Without a connection between their benefits management tools, data warehouses, or other business tools, it’s common for hospitals to hire a consultant to delve into each system and build manual reports.

Artemis works differently (and smarter). It can easily take feeds from any vendor, compare them quickly and easily, and generate visualizations that tell a complete story. Standard and custom reports are automatically ready and waiting anytime you log in.

We can find benefits spend waste.

While Artemis can be a great fit for hospitals, it’s also built to help employers find wasteful spending in their benefit programs. Unique and industry-standard data models can “bubble up” avoidable ER spending, prescription overspending, utilization and engagement data, and ROI. This helps hospital employers and others identify waste, take action, and maintain quality care.

For many employers, including hospitals, they’re not just looking at the bottom line. They’re concerned about attracting talented employees and providing competitive benefits.

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