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Prime Health Services

Prime Metrics

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 cost.

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.

Bullet -yellow -arrow What makes the Prime Metrics application so special?

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 provider.
  • A breakdown of all charges, fee schedule, PPO, and allowed amounts spent in a given month/year on an individual injured worker.
  • 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 treatment
  • 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.

Want More information?
For more information on this product/service, please contact Prime at 615-329-4098 to schedule a demonstration or click here to contact us.