The Challenge
Designing and Pricing Procedure Bundles
The client desired to design bundles from disparate sources of data that are often siloed in various POS and not been able to have a Single of Source of truth that are clinically acceptable procedures required during the episode and benchmarking the spend for the required procedures to set the price of the bundle.
Our Solution
Predictive Analytics and RFM Analysis
Our state-of-the-art predictive stack with an integrated BI solution engine enabled the client to analyze the procedures conducted on the members in various places of service (POS) during episode of care, before and after the knee replacement surgery, by creating a pre- and post-event timeline. Subsequent analysis scored procedures according to the pre/ post event analysis, and recency, frequency and monetary (RFM) analysis to determine procedure bundles and the spend conducted at each place of service setting. The analysis focused on the function of the most necessary procedures required from a set of claims remits and patient demographics in each POS, allowing clinicians to determine procedure bundle that achieves desired clinical outcomes at an optimal price.
The Results
Data-Driven, Clinically Acceptable Bundles
The predictive RFM solution enabled the client to create clinically acceptable and pragmatically priced procedure bundles. This data-driven approach allowed for the creation of fixed-cost bundles that ensure quality care while optimizing spend.
- Leverage our suite of predictive analytics capabilities to create a customized model for bundle formation and identify episodes of care.
- Define pragmatic bundles for the most valuable and important procedures without compromising the quality of care delivered.
- Ensure comprehensive knee replacement that can be bundled at a fixed cost of USD 40,300.
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Get In TouchFrequently Asked Questions
Find answers to common questions about our AI solutions.
The implementation timeline varies depending on the complexity of the project, data availability, and integration requirements. A typical project can range from a few weeks for a pilot to several months for a full-scale enterprise solution. We provide a detailed project plan with clear milestones at the outset.
The more high-quality, relevant data you have, the better. This can include historical sales data, customer behavior, operational logs, or unstructured data like text and images. Our team will work with you to assess your data assets and identify any gaps.
Data security is our top priority. We adhere to strict data protection protocols, including encryption, access control, and compliance with regulations like GDPR and CCPA. We are committed to ethical AI practices and ensuring your data is handled responsibly.
The ROI can be substantial, manifesting as increased revenue, reduced operational costs, improved efficiency, and enhanced customer satisfaction. We work with you to define key performance indicators (KPIs) and measure the impact of our solutions on your business goals.