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Use Case Medical Cost Containment

Medical cost containment requires a holistic view of the patient journey

The US spends 19.7% of its GDP on healthcare and this is projected to keep rising. To reduce costs, healthcare organizations must first understand the true cost of care for the patients they serve. Claims data is a rich source that includes information related to diagnoses, procedures, and utilization. To make sense of claims data, healthcare organizations need to acquire, aggregate, and enrich the data into a meaningful picture of the patient journey and associated costs.

The Challenge

Claims data is rich with information, but not always easy to parse

Claims data was built for accounting purposes and medical billing. It was not built for deep analysis into medical cost drivers. Analysts spend considerable time building basic metrics and trying to tell stories with claims data.

The Solution

A robust data platform can provide insights from claims to contain healthcare costs

When claims data are grouped and enriched into a set of actionable events, episodes, and classifications they tell a cohesive story about the patient journey. Healthcare organizations get a more detailed understanding of the full medical expense of a patient population to inform strategic decision making on cost and utilization.

Advanced risk adjustment analytics close risk gaps with accurate, comprehensive data.
Featured Applications

Medical cost containment applications

Get a deeper view of medical costs in your population with normalized and simplified medical economic data outputs. Tap into aggregated and enriched claims data to reduce duplicative work and accelerate analytic output.

Arcadia Foundry

Healthcare Data Model

Healthcare data model built by analysts, for analysts

Arcadia Vista

Analytics Dashboard

Business intelligence software built for healthcare organizations

Arcadia Bindery

Healthcare Reporting for Payers

Health plan and payer reporting delivered through secure email and web-based apps

Arcadia SDoH Package

Unified SDoH data

Improve health outcomes by streamlining the way you identify populations most in need of care

Latest Resources

Medical cost containment resources for leaders in healthcare

Let’s work together to contain medical costs

Get in touch to see how Arcadia can help you reduce medical costs across your population.