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Craneware Healthcare Intelligence

Healthcare Intelligence is the leader in automated Cost Analytics solutions that improve financial and operational performance for healthcare organizations. In a world of shrinking fee-for-service payment, the industry can no longer rely solely on revenue management to achieve its financial objectives; it must rely on accurate cost management technology and analytics.

Why Cost Matters

According to a report by McKinsey, 15 cents of every U.S. healthcare dollar goes toward revenue cycle processes, which are largely inefficient. Of the $2.7 trillion the country spends annually on health care, $400 billion goes to claims processing, payments, billing, revenue cycle management, and bad debt, partially due to the inefficiency of payor-provider transactions. In addition, physician groups and individual medical practitioners have concentrated their efforts on patient billing rather than on implementing effective financial controls across their revenue cycles. In response to this challenge, financial and clinical are coming together with a common goal of determining the true cost of healthcare delivery by patient, medical condition, location, service line, resource or caregiver, and population.

How is Craneware Solving this Problem?

Craneware’s market-driven SaaS solutions help hospitals and other healthcare providers more effectively price, charge, code, and retain earned revenue for patient care services and supplies. This optimizes reimbursement, increases operational efficiency, and minimizes compliance risk.

A focus of development within Craneware has been on gaining a greater understanding of the true cost of a patient’s episode of care. In order to achieve the goals of the company and its customers, Craneware has established Craneware Healthcare Intelligence (CHI), where a world-class solution has been built from the ground-up to provide a Cost Analytics platform that has the ability to review costs from each patient encounter from beginning to end.

What Does The CHI Solution Deliver?

Most hospitals’ accounting systems are set up to collect financial data in aggregate and average metrics. This structure, while useful in a fee-for-service system, is not conducive to support the shift to a value-based, quality-centric healthcare delivery system. Craneware Healthcare Intelligence’s solution is an innovative platform and application suite uniting cost and operational information across the provider organization, creating transparency and decision enablement insights. This provides revenue, cost, and operational information for each patient encounter – a series of temporarily related healthcare activities and services pertaining to the treatment of the patient’s medical condition, as determined by their attending physician. This encompasses all activity (including hospital and physician services) performed between admission and discharge for inpatients and services provided during each visit for outpatients. The solution allows health systems to trace the pathway of the patient experience from financial and operational perspectives. It enables understanding of the critical components of operational metrics and expenses across the entire episode of care.

What Makes CHI Unique?

CHI is shifting the traditional paradigm of cost tracking in hospitals.

Specific benefits of the CHI solution include:

  • Allows physicians to understand the impact their activities have on true costs by providing a retrospective view of physician behaviors and allows hospitals to assess their macro level activities by individual physician encounter.
  • Provides the ability to benchmark within, and outside of, the hospital network and determine best practices for their hospital(s).
  • Helps facilitate the development of bundled payment strategies as the shift toward compensating physicians based on quality improvements continues to occur, and one needs to be able to measure the rate of change and differentials at a specific point in time. Having such detailed information allows for things such as the approval of bundled payment applications for a given procedure. Understanding true costs of patient care allows the customer to effectively negotiate new payor contracts.

Other specific benefits of the CHI business intelligence tool:
  • Offered as a SaaS solution. There is no need to install any software on premises as all data analysis and processing will occur in the cloud.
  • The solution has the ability to import all customer data into a readily accessible cache which allows customers to run reports in minutes, rather than hours.
  • As a result of the readily available data, customers are able to autonomously create custom reports (visualizations) without the need of the CHI development team.
  • The custom visualizations allow the customer to compare their data against internally determined benchmarks, previous fiscal years, or other selected parameters. This provides information to make well-informed decisions around supplies rationalization, physician practice variance, and service line (medical condition) variance.