For those PPO clients of Prime that purchase this product, The Prime Metrics application creates a total window into the medical aspect of the claim.
Why did Prime create a Metrics product?
With all of the sophisticated programs in use today to control
medical costs, few if any know how well they actually work in
lowering the true cost of the medical claim. All of our clients
expect discounts with our contracted providers, but that does not
tell how well the client is doing in controlling the overall
Only recently with the ever growing ability of technology, both
descriptive and predictive metrics can now be studied from an
empirical standpoint as opposed to anecdotal, which the industry
has often relied upon. The best empirical data has been collected
by independent research firms, but this information is typically
for states and governments to use, not customized for an individual
client. Thus, Prime Health Services has created a sophisticated
metrics application, Prime Metrics, to work in conjunction or as a
standalone with our clients.
What makes the Prime Metrics application so
First and foremost, as with most Prime Health Services
technology and services, Prime customizes its products to
meet the needs of its clients. Thus, customized technology
solutions in conjunction with the core application sets this
product apart from the market! Moreover, The Prime Metrics system
has Intelligent Design. One key aspect is its ability to "Flag or
analyze" any potential problem(s) within a clients normalized data.
Our system is statistically sound and creates as stated above a
window into the medical dollars and treatment for the claim. We
compare outcome vs. overall medical costs. Prime Metrics "pulls
data" from our clients to normalize and analyze while at the same
time "pushes data" back to the client regarding the descriptive and
predictive metrics. If you are a client of Prime Health Services
PPO, we also consult with the providers assisting them to
understand the client's needs in relation to their results.
Examples of the hundreds of individual metrics
analyzed by this product:
- Identify the number(s) of injury types treated by each medical
- A breakdown of all charges, fee schedule, PPO, and allowed
amounts spent in a given month/year on an individual injured
- Identify recurring or multiple surgeries by medical provider
and also by injured worker.
- Number of days from date of Injury to first date of service for
- Statistical flags for providers performing outside of the norm
for costs and return to work timelines.
Intelligent Design is the way and means to offer more than just
a 'dashboard' type display of information. There are competitive
products in the market place that simply offers the "dashboard"
type stats. These are often found on the computers of hospital
administrators looking at raw statistical information. For outcomes
measurements to have any meaning there needs to be something that
we do with the data. So, the "push" information which alerts when
the formulary (pre-set on statistical norms) has been exceeded will
set the outcomes information apart.
This application can be integrated within the
claims system or accessible via web
portal. The client has total control to view their metrics
on their own time frame.
For more information on this product/service, please
contact Prime at 615-329-4098 to schedule a demonstration
or click here to contact us.