Deerwalk Blog

Solving the Math Problem of Pre-Existing Conditions and the ACA

Posted by Jeff Gasser on January 10, 2017

What is the price of offering insurance to folks with pre-existing conditions on the health exchanges and how do we solve the problem without putting in the mandatory insurance requirements under the Affordable Care Act regulations?

To understand this you first need to understand that health insurance is simply a reflection of the claims cost plus administration and profit. Next you need to understand the distribution of medical expenses, which can fluctuate with populations, co-pays,[...]

Medicare Reference Pricing - A Prescription to Fix the ACA

Posted by Jeff Gasser on November 01, 2016

Due to our presence in the Population Health Analytics space, I often get asked about what we should do about the Affordable Care Act ("ACA") and the declining choices at greatly escalating rates. As ACA open enrollment starts this week, I've been thinking a lot about this question, and I think it's timely to consider some solutions today. I look at a lot of data, so a couple of simple observations first. Health insurance isn't that complicated.  Add up total claims on a population and[...]

Deerwalk & ClearHealth - Like Surf & Turf for Medicare Reference Pricing

Posted by Maris Mejia on October 27, 2016

Reference Based Pricing Lately, all eyes are on Reference Based Pricing (RBP). In fact, it was standing room only at the Reference Based Reimbursement (RBR) discussion panel last month in Austin at SIIA's biggest event of the year. SIIA’s National Educational Conference & Expo is the world’s largest event dedicated exclusively to the self-insurance/alternative risk transfer industry. RBP was also a hot topic at the recent SPBA conference in Minneapolis, and it’s clear that many TPA’s are[...]

A Single Source of Truth in Population Health Analytics

Posted by Scott MacEwen on September 22, 2016

No, I am not talking about the Dalai Lama. I am talking about having a Population Health Analytics strategy that incorporates a Single Source of Truth (SSOT).  In the past this strategy was often synonomous with a healthcare data warehouse. But with Big Data solutions, it's commonly referred to as a "Data Lake".  More and more often, our customers refer to it as their single source of truth, so we decided to adopt the phrase and expand on it.

Finally....Medicare Reference Pricing embedded in my Population Health Analytics application!

Posted by Tim Huke on August 04, 2016

The more time I spent in the field this past spring, the more I heard from both existing and potential clients about the need to analyze plan allowed amounts against Medicare pricing equivalencies.  It's no secret that employers, brokers, consultants, TPA's and health plans are all considering various reference-based or Medicare-based pricing strategies in their plan designs.  Whether considering a total PPO replacement, a narrow network strategy complemented with Medicare pricing wrapped[...]

What is a Population Health Analytics Rules Engine and Why Should I Care?

Posted by Jeff Gasser on July 26, 2016

It seems like the more I look at websites in the healthcare IT space, the more confused I get. I don't know how many times I have read a website and come away thinking "Okay. Sounds impressive, but what do you actually do?" In fact, I have gotten away from using the generic term “analytics”, because it can mean almost anything and therefore means nothing. I like the term "rules engine", but even that can be confusing at times. I am sure many people think that if you've seen one, you've seen[...]

A Finer Grain: Deerwalk's Approach to Utilization in Population Health Analytics

Posted by Ed Hausman on June 16, 2016

Traditional population health analytics vendors calculate utilization through the use of ‘summary tables’. This approach aggregates information from medical claims about a visit, service or procedure and stores that information in a slimmed down format (the summary table itself) that is digestible on lower performing SQL servers. Each utilization type has a summary table – an ER Visit summary table, an Admission summary table, a CT Scan summary table – and these summary tables, rather than[...]

Top 5 Surgery Drivers and Healthcare Analytics

Posted by Jeff Gasser on June 09, 2016

One of the fun things about being in the healthcare analytics business is getting the chance to look at de-identified data from all over the country to see some of the things that tend to drive medical costs.  The key to having any meaningful analysis is to take the thousands of diagnostic and procedure codes and organize those codes into a small enough set of groupers that allows for a meaningful analysis.  We have over 6000 healthcare rules in our rules engine and none are more important[...]

6 Ways to Access Your Healthcare Analytics Data with Deerwalk

Posted by Jeff Rick on June 02, 2016

 I was recently on a call talking with a potential customer about our healthcare analytics service and during that conversation there were lots of questions about how to easily get the information stored in and delivered by our analytics application into various different audience’s hands.  During this conversation I went through and identified the various ways the clients can get access to the data and how they could potentially use those methods to deliver meaningful reports and analysis[...]

Beware of "Shiny Objects" in Healthcare Analytics

Posted by Jeff Gasser on May 26, 2016

Thursday, May 26, 2016

3:24 PM

The population health management world is filled with wonderful dashboards and data visualization tools - aka "shiny objects".   Many of these tools are becoming core components of healthcare analytics.  I have often been asked over the years by people looking for something to help them manage a patient population which tools made the most sense for their situation.I have also read countless RFPs that tried to rank tools based on certain features.  On the[...]

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