IBM Case Studies Mercy Health Select, LLC: The IBM Explorys Platform integrates disparate data sources to help identify at-risk patients

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	Mercy Health Select, LLC: The IBM Explorys Platform integrates disparate data sources to help identify at-risk patients IBM

Mercy Health Select, LLC: The IBM Explorys Platform integrates disparate data sources to help identify at-risk patients

IBM

Technology Category	Analytics & Modeling - Big Data Analytics Analytics & Modeling - Predictive Analytics
Applicable Industries	Healthcare & Hospitals
Applicable Functions	Quality Assurance
Use Cases	Predictive Maintenance
Services	Data Science Services
Challenge	Mercy Health Select, LLC, an accountable care organization (ACO) for the Medicare Shared Savings Program (MSSP), needed to improve the quality of care it provides by mining disparate data sources and identifying at-risk patients so that clinicians could intervene quickly. As an ACO, Mercy Health Select must demonstrate the ability to increase the quality of care while lowering costs. However, not all of the affiliated primary care providers (PCPs) in the Mercy Health Select network use the same electronic health record (EHR) platform, making it difficult to share information about at-risk patients among facilities. Insurance claims can bridge these gaps in data sharing, but facilities must submit and bill the claims before PCPs receive them— a process that can take as long as three months. Read More
About Customer	Based in Cincinnati, Ohio, and serving communities throughout Ohio and Kentucky, Mercy Health operates more than 450 health facilities, including 23 award-winning hospitals. Its services span all aspects of life, from maternity to senior care, and its net operating revenue in 2015 was USD 4.3 billion. Mercy Health Select, LLC, is an expanded network that supplements the organization’s 563 directly employed primary care providers (PCPs) with another 89 affiliated PCPs. In 2016, Mercy Health Select managed the care of nearly 150,000 patients in at-risk contracts. Read More
Solution	Mercy Health Select chose the IBM Explorys Platform from IBM Watson Health to help it in its journey toward value-based patient care. Using the Explorys Platform, Mercy Health Select can quickly gather all the pertinent claims and clinical information about its patients. The IBM Explorys EPM: Measure application then uses analytics to identify and prioritize high-risk, high-cost patients rapidly. The Explorys platform integrates claims and clinical data and then uses sophisticated analytics to identify and prioritize at-risk patients. Employees across the organization can use this information to provide better, more targeted care and improve the overall quality of Mercy Health Select’s services. Read More Log in to view content
Contents

Technology Category

Analytics & Modeling - Big Data Analytics

Analytics & Modeling - Predictive Analytics

Applicable Industries

Healthcare & Hospitals

Applicable Functions

Quality Assurance

Use Cases

Predictive Maintenance

Services

Data Science Services

Challenge

Mercy Health Select, LLC, an accountable care organization (ACO) for the Medicare Shared Savings Program (MSSP), needed to improve the quality of care it provides by mining disparate data sources and identifying at-risk patients so that clinicians could intervene quickly. As an ACO, Mercy Health Select must demonstrate the ability to increase the quality of care while lowering costs. However, not all of the affiliated primary care providers (PCPs) in the Mercy Health Select network use the same electronic health record (EHR) platform, making it difficult to share information about at-risk patients among facilities. Insurance claims can bridge these gaps in data sharing, but facilities must submit and bill the claims before PCPs receive them— a process that can take as long as three months.

About Customer

Based in Cincinnati, Ohio, and serving communities throughout Ohio and Kentucky, Mercy Health operates more than 450 health facilities, including 23 award-winning hospitals. Its services span all aspects of life, from maternity to senior care, and its net operating revenue in 2015 was USD 4.3 billion. Mercy Health Select, LLC, is an expanded network that supplements the organization’s 563 directly employed primary care providers (PCPs) with another 89 affiliated PCPs. In 2016, Mercy Health Select managed the care of nearly 150,000 patients in at-risk contracts.

Solution

Mercy Health Select chose the IBM Explorys Platform from IBM Watson Health to help it in its journey toward value-based patient care. Using the Explorys Platform, Mercy Health Select can quickly gather all the pertinent claims and clinical information about its patients. The IBM Explorys EPM: Measure application then uses analytics to identify and prioritize high-risk, high-cost patients rapidly. The Explorys platform integrates claims and clinical data and then uses sophisticated analytics to identify and prioritize at-risk patients. Employees across the organization can use this information to provide better, more targeted care and improve the overall quality of Mercy Health Select’s services.

Impact #1	The IBM Explorys platform provides breadth of data from the claims, along with freshness and depth from the clinical data.
Impact #2	Explorys uses EHR data to update risk scores daily, enabling quick follow-up with patients whose health risk has increased.
Impact #3	The Explorys Platform has helped Mercy Health Select in its commitment to value-based care, providing tools and insight to improve patient care.

Impact #1

The IBM Explorys platform provides breadth of data from the claims, along with freshness and depth from the clinical data.

Impact #2

Explorys uses EHR data to update risk scores daily, enabling quick follow-up with patients whose health risk has increased.

Impact #3

The Explorys Platform has helped Mercy Health Select in its commitment to value-based care, providing tools and insight to improve patient care.

Benefit #1	Mercy Health Select received an ACO score of 97.1 percent from the Centers for Medicare and Medicaid Services (CMS) in 2015, a full 5.7 percent higher than the average among all MSSPs.
Benefit #2	The higher ACO score translates into a higher portion of shared savings for Mercy Health Select.

Benefit #1

Mercy Health Select received an ACO score of 97.1 percent from the Centers for Medicare and Medicaid Services (CMS) in 2015, a full 5.7 percent higher than the average among all MSSPs.

Benefit #2

The higher ACO score translates into a higher portion of shared savings for Mercy Health Select.

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Overview

Mercy Health Select, LLC: The IBM Explorys Platform integrates disparate data sources to help identify at-risk patients

Operational Impact

Quantitative Benefit