Highmark has partnered with Cotiviti, Inc. to provide access to the Provider Intelligence (PI) Tool, which is an application that can be used to understand risk, cost, and performance across a provider's True Performance patient panel.
The application facilities risk identification and risk stratification, as well as pinpointing opportunities for clinically sound, financially effective interventions. The PI Tool enables you to reduce inefficient use of resources, optimize clinical value, improve the patient experience, and measure variation in quality and performance.
The PI Tool includes your panel of True Performance attributed patients. In the application you can:
- Design and measure the impact of care management and wellness programs
- Identify, implement, and evaluate actionable patient-level clinical interventions
- Improve the operational efficiency and clinical outcomes of patient outreach and engagement
- Drive accountable care strategies and inform other alternative quality contract initiatives
- Measure and improve year-round compliance with quality-of-care guidelines
Data can be viewed in the aggregate as well as at the patient-level. Data elements available include:
- Eligibility and Patient Demographics
- Medical Claims Information
- Pharmacy Claims Information
- Risk Scores and Drivers of Risk
- Lab Results
- Health Risk Assessment Responses
PI Tool Newsletter
Highmark creates a bi-annual newsletter for external PI Tool users to assist them in their efforts to improve health outcomes and reduce total cost of care. You can view the PI Tool Newsletter HERE.
Cotiviti Recorded Training Webinars
Session #1 - Provider Intelligence Training: Navigating Executive Dashboard
Session #2 - Provider Intelligence Training: ER Analysis Using ER Standard Dashboard
Session #3 - Provider Intelligence Training: ER Analysis with Focus on Likelihood Scores
Session #4 - Provider Intelligence Training: Inpatient Analytics with Focus on ACSC Admissions
To learn more about the PI Tool and how to perform specific functions within the tool, please view the videos below.
Video #1 - How to Look Up an Individual Patient
Video #2 - Batch Report Creator Functionality
Video #3 - Where to Find Avoidable Emergency Room Visit Data
Last updated on 12/2/2022 9:18:10 AM