Understand Your Clinical Network.
Grow Your Revenue.

Convert health plan claims data into your greatest revenue acceleration asset.

Quantify high-spend/high-volume services to return to your system.

Understand Your Clinical Network.
Grow Your Revenue.

Convert health plan claims data into your greatest revenue acceleration asset.

Quantify high-spend/high-volume services to return to your system.

Millions of dollars in charges are
escaping your system every month.

Network leakage results in lost revenue, lack of care coordination, and duplication of care. PopulationCompass delivers a detailed view of your clinical network and identifies the underlying causes of leakage, including out-of-network referral rates by PCP/Specialist/Service Line/Clinic/Location and out-of-network services that could have been easily provided by your Health System.

GROUP your clinicians into the right network “buckets”

We build your organizational hierarchy (and your competitors) to track rosters of clinicians by network, status (e.g., employed, affiliated, locum, etc.), and clinical concentration (e.g., proceduralists).

IDENTIFY where your patients receive care by TaxID, NPI, location, and frequency

We deliver an intuitive, rapid, visualization of each Patient’s Care Journey to understand the care happening outside the “4 walls” of your system.

SPOTLIGHT clinician variation and sleuth the departure points in your network

We highlight referral patterns and the origin of patient outflow to create clinician-level interventions and help establish patient care coordination priorities.

QUANTIFY network leakage

We measure at the individual patient level and aggregate by network, by clinic, by specialty, by clinician, by procedure, etc. so you have the granularity and detail to redirect care and increase revenue.

Our Solution

We start with claims data.

And then

Our clinical measurement experts will partner with your clinicians and administrators to:

Validate, aggregate, calculate, analyze, summarize, and visualize

So that

You are able to:

  • Increase internal referrals.
  • Decrease external referrals.
  • Convert out-of-network services into RVUs.
  • Better control “Total Cost of Care” contracts.
  • Prioritize patient access by location, service line, clinician.

Introducing

How your network is performing shouldn’t be a mystery.

PopulationCompass transforms claims data into easy-to-understand insights and simple visualizations that reveal clinician referral patterns and patient care outflow.

PMPM

Custom cohort modeling to identify immediate PMPM savings opportunities based on revenue cycle patterns. ESRD networks, $1,200 PMPM savings; Medicare Advantage networks, $380 PMPM savings; I-SNP networks, $850 PMPM savings.

Clinical Network Performance

Identify areas of network leakage/retention/steerage; spotlight origin of patient outflow to create care coordination priorities.

Attribution

Deliver clean counts and rosters for current health plan arrangement. Identify “overlaps” between “Members” (claims data) and “Patients” (EHR data).

Clinical Network “Single Source of Truth”

Along with the clinical network’s financial performance and intentional behavior, PopulationCompass delivers the accurate rosters of all clinicians and facilities participating in care with your patients. The constantly updated “roster” of billing actors, whether an obscure transportation provider or an overzealous DME supplier, becomes an important “single source of truth” that supports care coordination priorities.

Introducing

How your network is performing shouldn’t be a mystery.

PopulationCompass transforms claims data into easy-to-understand insights and simple visualizations that reveal clinician referral patterns and patient care outflow.

PMPM

Custom cohort modeling to identify immediate PMPM savings opportunities based on revenue cycle patterns. ESRD networks, $1,200 PMPM savings; Medicare Advantage networks, $380 PMPM savings; I-SNP networks, $850 PMPM savings.

Attribution

Deliver clean counts and rosters for current health plan arrangement. Identify “overlaps” between “Members” (claims data) and “Patients” (EHR data).

Clinical Network Performance

Identify areas of network leakage/retention/steerage; spotlight origin of patient outflow to create care coordination priorities.

Clinical Network “Single Source of Truth”

Along with the clinical network’s financial performance and intentional behavior, PopulationCompass delivers the accurate rosters of all clinicians and facilities participating in care with your patients. The constantly updated “roster” of billing actors, whether an obscure transportation provider or an overzealous DME supplier, becomes an important “single source of truth” that supports care coordination priorities.

We combine our software, advanced analytics, and expertise to help you improve clinical outcomes and financial performance.

4-month QuickStart

A Safe, Fast, Low-risk Approach to Immediate Revenue

0 Days

Our Analytics-as-a-Service approach will deliver insights you can leverage within the first 30 days. We work collaboratively with your clinic operations teams to get several early wins, building awareness as we quantify the revenue to recapture by Department, by Health Plan, by Value-Based Agreement.

Jumpstart Phase:
Primary Care + 1 Specialty Care

January – March 2024

  • Data Visualization of Patient Care Journey

  • Referral Patterns to/from

  • Quantification of Patient Revenue Lost to External Delivery Networks

  • Top 5 Revenue “Recapture” Procedures + Services for the + 1 Specialty Care Department

  • Leakage Dashboard

Expand:
Multiple Departments

April – December 2024

  • Health Plan Member Assignment Reconciliation

  • Patient + Physician Panel Construction

  • Clinician Roster “Green List” + “White List” + “Red List”

  • Total Cost of Care Tracking + Modeling

  • Leakage per Clinician, per Clinic, per Department

We Deliver Your Data Quickly

Deployed within your existing infrastructure
(no additional investment) and within 4 weeks!

Easy as One, Two, Three.

Choose ONE

Health Plan Claims Data Source

Choose TWO

Clinical
Departments

Choose THREE

Priority Patient Cohorts

Live insights in your hands
in FOUR weeks.

We Deliver Your Data Quickly.

Deployed within your existing infrastructure
(no additional investment) and within 4 weeks!

Easy as 1, 2, 3.

Choose ONE

Health Plan Claims Data Source

Choose TWO

Clinical Departments

Choose THREE

Priority Patient Cohorts

Live insights in your hands in FOUR weeks.

Take a quick tour of PopulationCompass.