SYSTEMS AND METHODS FOR PERFORMING MULTIDIMENSIONAL QUERIES ON HEALTHCARE PROVIDER INSTITUTIONAL DATA
Systems and methods disclosed herein provide tools that provide institutions financial visibility in new and/or reformed initiatives by providing insight into the consistency and efficiency of relevant services. A multidimensional query may be performed on institutional data to generate a results set. A baseline model may be generated based off of the results set. One or more adjustments to the baseline model may then be applied to generate a predictive model. The predictive model may then be compared to the baseline model to generate a predicted change in the financial metrics.
1 . A method for performing horizontal analysis of institutional data of a healthcare provider, the method comprising:
receiving an indication of two or more dimensions for a multidimensional query;
performing a multidimensional query of historical data on the two or more dimensions;
generating a set of results based upon the multidimensional query;
determining a baseline model based on the set of results;
receiving an adjustment to a parameter of the baseline model to generate a predictive model; and
simultaneously displaying the adjustment, a first summary financial metric for the baseline model, a second summary financial metric for the predictive model, and at least one difference between the first summary financial metric and the second summary financial metric.
2 . The method of claim 1 , wherein the multidimensional query is a three dimensional query, and wherein the three dimensions comprise:
patient criteria;
trigger conditions; and
claim criteria.
3 . The method of claim 2 , further comprising receiving at least a first set of factors for the patient criteria as parameters for the multidimensional query, and wherein the first set of factors include at least one of:
financial data;
payer data;
location;
gender;
age;
diagnosis; and
name.
4 . The method of claim 3 , further comprising receiving a second set of factors for the trigger conditions as parameters for the multidimensional query, and wherein the second set of factors include at least one of:
a service;
an action; and
a medical event.
5 . The method of claim 4 , wherein the historical data includes data relating to multiple payers and the parameter is a vertical parameter that affects a first payer of the multiple payers but not a second payer of the multiple payers.
6 . The method of claim 4 , further comprising receiving a third set of factors for the claim criteria as parameters for the multidimensional query, and wherein the third set of factors include at least one of:
place of service;
code type; and
providers.
7 . The method of claim 1 , wherein the parameter comprises part of the set of results, and receiving an adjustment to the at least one parameter comprises receiving an adjustment to at least one of:
a reimbursement amount;
a supply cost; and
a number of units.
8 . The method of claim 1 , wherein the first and second summary financial metrics each comprise at least one of:
total cost;
reimbursement value; and
net revenue.
9 . The method of claim 1 , wherein the parameter is calculated from the set of results when determining the baseline model.
10 . A computer storage medium encoding computer executable instructions that, when executed by at least one processor, perform a method for performing horizontal analysis of institutional data of a healthcare provider, the method comprising:
receiving an indication of two or more dimensions for a multidimensional query;
performing a multidimensional query of historical data on the two or more dimensions;
generating a set of results based upon the multidimensional query;
determining a baseline model based on the set of results;
receiving an adjustment to a parameter of the baseline model to generate a predictive model; and
simultaneously displaying the adjustment, a first summary financial metric for the baseline model, a second summary financial metric for the predictive model, and at least one difference between the first summary financial metric and the second summary financial metric.
11 . The computer storage medium of claim 12 , wherein the multidimensional query is a three dimensional query, and wherein the three dimensions comprise:
patient criteria;
trigger conditions; and
claim criteria.
12 . The computer storage medium of claim 10 , wherein the method further comprises receiving at least a first set of factors for the patient criteria as parameters for the multidimensional query, and wherein the first set of factors include at least one of:
financial data;
payer data;
location;
gender;
age;
diagnosis; and
name.
13 . The computer storage medium of claim 12 , wherein the method further comprises receiving a second set of factors for the trigger conditions as parameters for the multidimensional query, and wherein the second set of factors include at least one of:
a service;
an action; and
a medical event.
14 . The computer storage medium of claim 13 , wherein the historical data includes data relating to multiple payers and the parameter is a vertical parameter that affects a first payer of the multiple payers but not a second payer of the multiple payers.
15 . The computer storage medium of claim 13 , wherein the method further comprises receiving a third set of factors for the claim criteria as parameters for the multidimensional query, and wherein the third set of factors include at least one of:
place of service;
code type; and
providers.
16 . The computer storage medium of claim 10 , wherein the parameter comprises part of the set of results, and receiving an adjustment to the at least one parameter comprises receiving an adjustment to at least one of:
a reimbursement amount;
a supply cost; and
a number of units.
17 . The computer storage medium of claim 10 , wherein the first and second summary financial metrics each comprise at least one of:
total cost;
reimbursement value; and
net revenue.
18 . The computer storage medium of claim 10 , wherein the parameter is calculated from the set of results when determining the baseline model.
19 . A method for performing vertical analysis of institutional data of healthcare provider, the method comprising:
receiving an indication of two or more dimensions for a multidimensional query;
performing the multidimensional query of historical data on the two or more dimensions, wherein the multidimensional query defines a population, and wherein the population comprises a plurality of payers;
generating a set of results based upon the multidimensional query;
determining a baseline model based on the set of results;
receiving an adjustment to a parameter of the baseline model to generate a predictive model, wherein the parameter is a horizontal parameter that affects multiple payers in the plurality of payers and affects a first payer of the plurality of payers differently from a second payer of the plurality of payers; and
applying the adjustment across the plurality of payers to generate a predictive model.
20 . The method of claim 19 , further comprising simultaneously displaying the adjustment, a first summary financial metric for the baseline model, and a second summary financial metric for the predictive model.