platform_og_phone_full-file-_-alllll-05Performance Management Analytics

Our prescriptive analytics platform provides actuarially-driven performance analytics and advisors to predict “in-year” financial performance to improve the cost, quality and utilization of any risk-based contract. It’s one thing to draw insights from your data, but true power comes when you use those insights to deliver tangible results.

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Data is Only Significant if it is Actionable

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Deep Analysis with 360-Degree View

Detailed analyses of healthcare performance and financial data, including actuarial-driven benchmarks, are complemented by experience-driven insights from our industry experts. With a comprehensive and holistic view of all financial, clinical, and operational opportunities, you can eliminate department-centric perspectives and work towards a common goal.

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Predictive Modeling

Cedar Gate is uniquely suited to serve as a shared point of contact and communication among healthcare organizations with 30+ years in bundled payment arrangements. Our platform identifies and develops bundle opportunities to reduce spend and improve quality of care.

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Leakage Capture

Identify revenue and out-of-network referral recapture for all aspects of the health care value chain (specialty physician and facility out-of-network utilization). Identify sources of out-of-network activity and services rendered at out-of-network provider organizations. Manage revenue capture and enhanced care coordination by identifying primary care physician’s out-of-network referrals.

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Prescriptive Advisors

Empower yourself with timely information to take action and accomplish your performance goals. Our platform combines deep, detailed analyses of healthcare performance and financial data backed by a team of highly accomplished physicians, data scientists, healthcare executives, financial analysts, and actuaries. This industry-leading platform delivers your data in the form of an action plan that enables you to focus on what needs attention most.

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Appropriate Care Measures

Overtreatment is one of the root causes for the affordable care crisis, accounting for $760 billion in annual costs. To address the issue, Cedar Gate has partnered with the Global Appropriateness Measures Group (GAM), a collaboration of healthcare experts committed to the goal of measuring high-value care and reducing waste.

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Actionable Insights & Workflows

Effectively create predefined and custom workflows or “plays” to drive improvements in financial, operational, and clinical performance. Use your pricing, claims, and utilization data to reveal the projected value and potential timetable of a play before you begin. Once you execute a play, then monitor, track, and display performance data, while receiving updated action items to improve performance throughout the year—not just at year-end.

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Medical Loss Ratio

Forecast and manage Medical Loss Ratios by line of business, network, region and more. Then through clinical and financial advisors, configure and model improvement options. This allows you to gain visibility into predictable, continuous operational changes for your healthcare delivery system, positively affecting thousands of lives and saving millions of dollars.

CUSTOM CAPABILITIES

We know your business has unique needs and requirements. For that reason, we offer a number of customizable solutions that are available within our platform.


Value-Based Performance Needs

Governed by standard, custom development processes, we work with you to define scope, requirements, project cost, and timeline to deliver solutions specific to your value-based care performance needs.

Enable rapid innovation through complementary custom reporting solutions that help expedite your success in the same performance year.

Develop one-off, customized analytics and reports to address challenges and opportunities that are unique to your organization.

Serving

payers

Payers

Manage risk more effectively and obtain greater value for every healthcare dollar.

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providers

Providers

Act on emerging opportunities to transform operations and improve financial performance.

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employers

Employers / ASOs

Recognize high-value innovation opportunities in healthcare with our help.

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Discover More

Product Page
Product Page

EZ-CAP – Core Administration

EZ-CAP is part of a comprehensive software platform…

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Product Page

EZ-CARE – Utilization / Case / Care Management

Superior care management for comprehensive continuum of care support

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eBrief

Three Common Challenges IPAs Face — and How You Can Mitigate Them

As a physician, you want to spend your time caring for patients…

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eBrief

Four Ways MSOs Can Maximize Efficiencies and Enhance Their Growth Opportunities

A host of regulatory changes and added complexities are driving renewed interest in MSOs…

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SOLUTIONS

Cedar Gate’s enterprise performance management analytics and administration platforms reduce risk, enhance financial performance, and improve patient outcomes for healthcare organizations across the value-based care continuum.

Enterprise Data Management

Capture, organize, and utilize all valuable data sets securely and easily.

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Transform the way you report on your business with these intelligent tool sets.

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Support medical management activities across the care continuum.

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Manage patients effectively from chronic conditions to transitions of care.

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Administer retrospective and prospective bundled payment arrangements with clinical excellence.

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Operate multiple lines of business with claims and benefits administration, eligibility, capitation reconciliation, financial management and more.

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Extend your effectiveness with managed, professional, or advisory services.

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