Analytic Tools & Data Mining

Prevention
Approximately 75% of healthcare costs stem from preventable chronic conditions such as heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes. Identifying inherent risks within a population and implementing prevention programs greatly decrease overall healthcare spending. 

Diabetes, Cardiac and other condition risk factors: Impactable Reports
Impactable Reports are highly customized and actionable report solutions that meets each customer’s individual analyses and forecast requirements. 

Wellness Reporting/ Cost Management

Shasta Administrative Services has the ability to access reports that focuses on conditions and risk factors, and how modified behavior can lower costs and improve productivity, providing the roadmap for investment in health and productivity. These reports can also measure changes in targeted behavior, indicators for clinical improvement, high cost utilization trends, savings and ROI.  

• Experience Reports: Displays claims paid, fixed costs and claims that apply to the aggregate stop loss contract

• Paid Claims Summary by Hospital/ Professional Services Report: Break down of paid claims by Hospital and Professional Services

• Total Paid by Benefit Code Report: Illustrates payments made by benefit usage within a certain coverage type, i.e., Medical or Dental

• Illustrates payments made by benefit usage within a certain coverage type, i.e., Medical or Dental: Paid claims for a given department grouped by month and year

• Paid Claims by Product Report: Aggregate claim dollars paid by product for paid date range specified, regardless of the incurred date

• PPO Savings Report: Illustrates PPO network savings by Inpatient, Outpatient, Physician and other. Savings are separated by the Primary Network, Secondary (Wrap) Network and fee negotiations

• Monthly Check Register: Illustrates all Payments, Voids and Refunds for a specified time period

• Patients Over a Specific Dollar Amount - Specific Stop Loss Report: Displays participants whose claim payments exceed the amount entered at run time for a product
   
• Medicare Like Rates (MLR) Savings Report (Tribal clients only): Tracks savings realized through the application of Medicare Like Rates
   
• ICD9 & ICD10/Diagnosis Report: Illustrates Payments made for a given diagnosis, or grouping identifying individuals for disease status or large claims
   
• Group Summary Report: At-a-glance overview showing benefit analysis, disallowed charges, claim costs & counts, top providers and census information
   
• Customizable Reporting Packages: Although Shasta already has over 400 comprehensive reporting packages built into our system, we remain flexible and will tailor additional reports to meet the needs of each of our clients.