Our analytics-driven solutions enable healthcare providers to improve health outcomes by driving quality of care with a patient-centered approach, optimize care delivery by closing care gaps and tracking performance, implement precision medicine by personalizing patient care, and enhance patient engagement by improving patients relationship, and effectively manage revenue cycle with advances of machine learning and AI.
Care Delivery Optimization
Quality Measures Performance
Care Delivery Optimization
Quality Measures Performance
Improve Health Outcomes with Analytics-Driven Solutions
Improvement of health outcomes has become imperative in value-based care, where the quality of care rests upon the value which it was derived from. With the advances of analytical tools and technologies, providers can capitalize on the potential of data science and AI to make informed decisions and maximize the value of care by improving health outcomes.
Out analytics-driven solutions help providers achieve the best results in the quality of care, measure clinical performance effectively, and to close gaps in care. With the Stelt strategic tools you will be able to:
Improvement of health outcomes has become imperative in value-based care, where the quality of care rests upon the value which it was derived from. With the advances of analytical tools and technologies, providers can capitalize on the potential of data science and AI to make informed decisions and maximize the value of care by improving health outcomes.
Out analytics-driven solutions help providers achieve the best results in the quality of care, measure clinical performance effectively, and to close gaps in care. With the Stelt strategic tools you will be able to:
- Develop a wide range of quality metrics and key health performance indicators
- Improve diagnosis accuracy and timely identify potential risks and complications
- Optimize population health management system with patient stratification
- Boost patient satisfaction with telemedicine and remote health monitoring
- Employ precision medicine to enhance a patient-centered care approach
- Incorporate the social determinants of health to drive better health outcomes
Optimize Care Delivery processes to drive Performance Excellence
High quality of care necessitates care delivery optimization in the achievement of the quadruple aim of value-based care: improved healthcare outcomes, improved patient experience, improved staff experience, and reduced costs. Optimization of care delivery that leverages data-driven technologies and solutions allow healthcare providers to make informed decisions about administrative and organizational strategies of delivery of care.
Stelt Care Delivery Optimization solutions enable providers to proactively identify waste and inefficiency in resource allocation, track key performance indicators, and maximize ROI. Our analytical solutions will help you to:
High quality of care necessitates care delivery optimization in the achievement of the quadruple aim of value-based care: improved healthcare outcomes, improved patient experience, improved staff experience, and reduced costs. Optimization of care delivery that leverages data-driven technologies and solutions allow healthcare providers to make informed decisions about administrative and organizational strategies of delivery of care.
Stelt Care Delivery Optimization solutions enable providers to proactively identify waste and inefficiency in resource allocation, track key performance indicators, and maximize ROI. Our analytical solutions will help you to:
- Manage shared savings programs effectively to maximize reimbursements
- Maximize the value of health outcomes achieved per unit of cost spent
- Identify high-cost high-risk populations and inefficient care delivery patterns
- Implement effective change in workflows and staff enabling capabilities
- Reduce waste, redundancy, unnecessary orders, and medical errors
- Focus on affordability, access, and coordination of the care delivery system
Enhance Patient Engagement with Data-Driven Technologies
Patient engagement ultimately leads to greater patient satisfaction, improved experiences, and better health outcomes. With enhanced patient engagement strategies using analytics and data-driven solutions providers can empower patients to be more active in their own health care and motivate them to improve their personal health outcomes and reduce medical costs.
Stelt Patient Engagement Enhancement Solutions enable physicians to take a more active role in preventative care and to improve their relationship with patients with interactive data-driven technologies and analytical tools. With our analytical tools, you will be able to:
Patient engagement ultimately leads to greater patient satisfaction, improved experiences, and better health outcomes. With enhanced patient engagement strategies using analytics and data-driven solutions providers can empower patients to be more active in their own health care and motivate them to improve their personal health outcomes and reduce medical costs.
Stelt Patient Engagement Enhancement Solutions enable physicians to take a more active role in preventative care and to improve their relationship with patients with interactive data-driven technologies and analytical tools. With our analytical tools, you will be able to:
- Integrate data from diverse sources into a unified technology infrastructure
- Assess patient health literacy rates and employ educational resources
- Aggregate data across the continuum of care to manage population health
- Transform patient portals and telemedicine data into analytical insights
- Streamline real-time health data into an integrated technology infrastructure
- Improve relationship with patients with interactive data-driven technologies
Individualize treatment based on unique biomarkers
Precision medicine is a novel approach for disease treatment and prevention with a primary focus on the individual characteristics of a patient rather than the population average. This approach allows clinicians to make accurate predictions about treatment and prevention strategies with advances of machine learning and AI. While the prospect of precision medicine leveraging machine learning is very promising, it may pose some initial challenges in generating clinically actionable insights.
At Stelt, we are here to help you to overcome those challenges and drive positive results. Our stratification algorithms enable clinicians to create and explore specific disease cohorts, identify biomarker groupings in a more holistic manner, and ultimately improve clinical outcomes. With our Precision Medicine Implementation solutions, you will be able to:
Precision medicine is a novel approach for disease treatment and prevention with a primary focus on the individual characteristics of a patient rather than the population average. This approach allows clinicians to make accurate predictions about treatment and prevention strategies with advances of machine learning and AI. While the prospect of precision medicine leveraging machine learning is very promising, it may pose some initial challenges in generating clinically actionable insights.
At Stelt, we are here to help you to overcome those challenges and drive positive results. Our stratification algorithms enable clinicians to create and explore specific disease cohorts, identify biomarker groupings in a more holistic manner, and ultimately improve clinical outcomes. With our Precision Medicine Implementation solutions, you will be able to:
- Make decisions based on individual features rather than on population average
- Apply finer and more accurate stratifications of patients based on biomarkers
- Create individualized treatment strategies to produce better health outcomes
- Understand the deeper relationship between social determinants and health outcomes
- Predict the risk of an individual patient developing a certain disease or condition
- Define dynamic patterns of health and disease and create efficient models of care
Increase profit margins with optimized operational performance
Revenue Cycle greatly impacts financial performance if managed inefficiently. When it comes to improving the efficiency of the revenue cycle management, analytics-driven solutions equipped with machine-learning algorithms offer granular insights into the RCM performance and allow providers to obtain real-time intelligence to make informed business decisions in a timely manner. And as the transition to value-based care gains momentum, the demand for efficiency and sustainability will become more prominent in the years to come.
At Stelt, we understand the value of machine learning and data intelligence in Revenue Cycle Management and driving positive outcomes and achieving a healthy bottom line. With the Stelt analytics-driven tools you will be able to:
- Optimize administrative and operational performance and increase profit margins
- Identify payer-specific payment behaviors and claims remittance patterns
- Manage high-value denials proactively with data mining and predictive analytics
- Compare performance, denial rates, and underpayment amounts across payers
- Improve the workflow of the authorization process and referrals for procedures
- Utilize visualization tools and dashboards to turn data into actionable insights
Lead the way in the value-based care with best quality performance
Quality measures help to measure or quantify health care processes, outcomes, patient perceptions, and organizational structure. The primary purpose of performance measurement should be to identify opportunities to improve patient care. Measures inform us about how the health care system is performing and help identify weaknesses, prioritize opportunities. Measures can also prevent the overuse, underuse, and misuse of health care services and can identify disparities in care delivery and outcomes.
Measures are used for quality improvement, benchmarking, and accountability; and are becoming increasingly important as the U.S. health care system shifts away from traditional fee-for-service toward payment focused on the value of care.
At Stelt, we are here to integrate Quality Measures Performance key indicators into your assessment process in supporting value-based care. Our solutions will allow you to:
Quality measures help to measure or quantify health care processes, outcomes, patient perceptions, and organizational structure. The primary purpose of performance measurement should be to identify opportunities to improve patient care.
Measures are used for quality improvement, benchmarking, and accountability; and are becoming increasingly important as the U.S. health care system shifts away from traditional fee-for-service toward payment focused on the value of care.
At Stelt, we are here to integrate Quality Measures Performance key indicators into your assessment process in supporting value-based care. Our solutions will allow you to:
- Reduce variability in measure selection, specifications, implementation, and reporting
- Reduce administrative burden for family medicine physicians
- Track implementation and adoption by all public and private payers use the ACO and PCMH
- Align with national or regional initiatives, such as the MIPS and Core Quality Measures Collaborative
- Address perceived or known gaps in care in the population you serve
- Compare your quality indicators based on benchmarking values across peer groups
Stelt delivers the best analytical solutions for commercial and government payers to drive quality of care and containing costs. Our data-based solutions enable payers to assess provider performance by employing a wide array of quality metrics and key performance indicators, timely detect fraud, waste, and abuse by gaining strategic intelligence with machine learning and AI, optimize provider network by capitalizing on high-performing providers, successfully transition into value-based care and innovate care management by utilizing population stratification.
Provider Performance Assessment
Provider Network Optimization
Value-Based Care Transition
Care Management Innovation
FWA Detection
Claim Process Automation
Provider Performance Assessment
Provider Network Optimization
Value-Based Care Transition
Care Management Innovation
FWA Detection
Claim Process Automation
Drive performance improvement across provider groups
Provide performance assessment plays an integral role in value-based care and serves as a beacon in continuous improvement of health care quality and efficiency. Models such as Accountable Care Organizations (ACO), Patient-Centered medical homes (PCMH), and bundled payment arrangements are primarily focused on provider performance metrics in terms of quality of care. Selecting the right performance metrics is vital in ensuring the availability of reliable performance information. Our Provider Performance assessment and benchmarking models allow payers to go beyond the traditional costs, quality, and utilization metrics by incorporating patient engagement patterns, social determinants of health, patient access, and satisfaction.
Our scoring algorithms enable to measure performance by taking account of three indicators for assessing the quality of healthcare providers: clinical outcome, patient satisfaction, and quality of life. With the Stelt Provider Performance solutions you will be able to:
- Compare metrics across provides and peer groups in an objective manner
- Utilize population-based metrics for specific provider groups
- Apply adjustment for the mix of episodes or clinical severity
- Identify preferred specialty physicians for future referrals
- Develop metrics to address each component of the triple aim
- Design metrics for a particular value-based payment arrangement
- Evaluate physician groups for participation in a narrow networks
- Drive performance improvement across hospitals and providers
Optimize administrative and operational performance
Provider network optimization targets key operational areas in healthcare organizations that lead to high-quality care, lower costs, and better overall financial and business performance. An optimized provider network offers transparent care by leveraging an effective working relationship with providers and capitalizing on advance analytical methods and data intelligence strategies. Healthcare organizations that effectively manage and engage their networks can see significant performance results in the form of revenue growth and waste reduction.
The Stelt Provider Network Optimization solutions enable payers to build high-performance networks and identify opportunities in the existing networks. With our customized robust analytical tools, coupled with the right engagement strategy you will be able to:
Provider network optimization targets key operational areas in healthcare organizations that lead to high-quality care, lower costs, and better overall financial and business performance. An optimized provider network offers transparent care by leveraging an effective working relationship with providers and capitalizing on advance analytical methods and data intelligence strategies. Healthcare organizations that effectively manage and engage their networks can see significant performance results in the form of revenue growth and waste reduction.
The Stelt Provider Network Optimization solutions enable payers to build high-performance networks and identify opportunities in the existing networks. With our customized robust analytical tools, coupled with the right engagement strategy you will be able to:
- Design and measure key performance indicators in network performance
- Stratify populations for enhanced health outcomes strategies
- Identify and reduce network leakage risks and out-of-network financial impacts
- Formulate incentives based on the patient-centered and evidence-based approach
- Compare costs and quality on various benchmarking platforms
- Differentiate between costs and utilization within high-risk populations
- Incorporate HPN quality measures targeting specific member cohorts
- Quantify and compare results of reimbursement methods and incentive arrangements
Manage shared savings contracts with expertise and precision
The transition from fee-for-service to fee-for-value offers a holistic approach to health care and is exceeding advantageous when it comes to improving health outcomes, yet at the same time, it poses great financial challenges to healthcare organizations. To overcome those challenges, payers must leverage analytical technologies to lay a strong analytics foundation that not only will help to meet those challenges, but also will provide strategic insights to succeed in the transition from volume-based to value-based reimbursement models.
At Stelt, we are here to help you build that analytical foundation in supporting the value-based care transition and achieving the best results with value-based care models. Stelt Value-Based Care Solutions are designed to help you to:
The transition from fee-for-service to fee-for-value offers a holistic approach to health care and is exceeding advantageous when it comes to improving health outcomes, yet at the same time, it poses great financial challenges to healthcare organizations. To overcome those challenges, payers must leverage analytical technologies to lay a strong analytics foundation that not only will help to meet those challenges, but also will provide strategic insights to succeed in the transition from volume-based to value-based reimbursement models.
At Stelt, we are here to help you build that analytical foundation in supporting the value-based care transition and achieving the best results with value-based care models. Stelt Value-Based Care Solutions are designed to help you to:
- Track a wide variety of cost, quality, and utilization measures and indicators
- Develop an agile plan to implement a transition to value-based care payment models
- Understand the current state of readiness and foundational strengths in data management
- Design better care models that lower costs and support better health outcomes
- Identify key strategies required for realignment of the existing reimbursement process
- Define provide performance cost and quality metrics for ACO and PCM contracts
- Manage shared savings contracts and bundled payments with expertise and precision
- Incentivize new high-performance provider networks for value-based contracts
Leverage social determinants to refine Health Care strategies
Care management innovation solutions with analytics-driven technologies can potentially alleviate the financial burden and complexity of an overloaded care delivery system. The integration of tools, such as telemedicine and telehealth monitoring, enables remote care coordination and effective resource allocation. Innovative care management extends beyond the standard care coordination and disease management and focuses on improved health outcomes, enhanced patient engagement, and cost containment. Healthcare organizations that use analytics-based technologies to drive their care management programs are far ahead of their competitors in value-based care.
Stelt Care Management Innovation Solutions are aimed to help you to revolutionize your Care Management models with the power of analytics-driven technologies and data science, which will enable you to:
Care management innovation solutions with analytics-driven technologies can potentially alleviate the financial burden and complexity of an overloaded care delivery system. The integration of tools, such as telemedicine and telehealth monitoring, enables remote care coordination and effective resource allocation. Innovative care management extends beyond the standard care coordination and disease management and focuses on improved health outcomes, enhanced patient engagement, and cost containment. Healthcare organizations that use analytics-based technologies to drive their care management programs are far ahead of their competitors in value-based care.
Stelt Care Management Innovation Solutions are aimed to help you to revolutionize your Care Management models with the power of analytics-driven technologies and data science, which will enable you to:
- Improve care coordination from resource allocation to funding initiatives
- Reduce avoidable readmissions, emergency department visits, and LOS
- Create individualized treatment strategies to produce better health outcomes
- Leverage social determinant assessment to further refine care strategies
- Apply the appropriate level of services based on clinical condition complexity
- Identify gaps in care and effectively allocate clinical resources and staff
- Coordinate care with the integration of telehealth monitoring and data analytics
- Track developing trends and risks with telemedicine for timely preventions
Detect and identify Fraud, Waste, and Abuse in timely manner
Fraud, waste, and abuse cost the US healthcare payers billions of dollars each year, which potentially leads to increased health care costs and insurance premiums. Because of the complexity and prevalence of FWA, it is important that healthcare payers combat these criminal practices with advanced analytical tools. Data Science and AI can be leveraged to detect and prevent FWA across the healthcare industry, particularly in highly targeted programs such as Medicare and Medicaid.
Stelt FWA Solutions enable payers to detect and identify suspicious activities in the claims process in a timely manner:
- Measure providers’ cost and utilization against their peer groups
- Track payment trends and highlight outliers for providers, procedures, and diagnoses
- Zoom in on spikes in payment and billing trends, and unusual observations
- Detect novel patterns of unusual behavior in the claim submission process
- Validate and improve existing FWA detection models and algorithms
- Identify possible up-coding, unbundling, unnecessary services, and kickbacks
- Examine relative risk scores for providers with high payment distributions
- Pinpoint outlier providers within peer groups, specialties, and geographic regions
Mitigate claim inaccuracies with Intelligent Automation
With claims process automation, payers can mitigate claim costs and reduce discrepancies. Process automation can accelerate the time to claim resolution, improve the accuracy of claim amounts, and increase customer retention resulting in greater customer loyalty over time.
Claim Process Automation with Stelt proprietary algorithms which uses artificial intelligence to detect fraudulent reporting by analyzing images, and integrating unstructured data with NLP and other data sources to build an accurate risk profile and alerts. These AI and ML powered automation capabilities can enable insurers to improve their existing business processes and apply automation technologies to make them more efficient.
With Stelt Intelligent Automation, you will be able to:
- Integrate historical data into Machine Learning models within the claims process
- Simplify the complexities of the claims handling process by automating handling steps
- Improve the claim handling process and more accurately evaluate the cost of risk scores
- Reduce transaction processing time and workload, and eliminate errors
- Increase efficiencies by alleviating overhead, and avoiding manual errors
- Utilize AI capability with intelligent automation to analyze data and detect fraud in real-time
- Improve the customer claims filing experience with a simpler and faster filing solution
- Lower the risk of incurred losses, loss-adjustment expenses, and administrative expenses