Provider Practice Pattern Data Quality Services

Transform provider practices for better results

Medicaid programs strive to provide the best care within a challenging environment. It can be hard to attract and retain high-quality providers when reimbursement rates are typically lower than Medicare and commercial contracting rates. Once on board, some providers may not always comply with the evidence-based care guidelines for people with chronic conditions, which can drive costs higher.

Optum™ can help. By providing better primary care for people with common chronic conditions, Medicaid programs can reduce emergency department and inpatient costs. Using advanced analytics and expert insight, Optum and The Lewin Group can help states and their Medicaid stakeholders identify key providers and help them transform practices to deliver the right care at the right time.

Leveraging advanced analytics and deep experience, experts from Optum™ and The Lewin Group can help your agency and other stakeholders:
  • Identify providers who have enrollees with higher than average rates of chronic conditions
  • Pinpoint workforce shortage areas and capacity needs
  • Profile providers to help support program efficiency analysis and identify cost variation
  • Recommend ways to improve quality without compromising access or increasing costs
  • Model the impacts of proposed recommendation to determine likely cost savings and quality improvement

Provider Practice Pattern Data Quality Services can help state Medicaid programs:
  • Improve population health by promoting preventive care, integrating and coordinating person-centered care, and incentivizing evidence-based care for treatment of common chronic conditions
  • Close the gaps between recommended care and provided care by helping providers understand and systematically deliver the right care every time
  • Increase program sustainability by rebalancing services to be more effective and accessible