4-page Partner Case Study - Posted 12/28/2009
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MedeAnalytics Experiences Rapid Growth with Compelling Software-as-a-Service Solution for the Healthcare Industry
ISV Solution Provider: MedeAnalytics
Software-plus-Services Platform of Choice: Microsoft
Case Study Highlights
- MedeAnalytics’ high-value Software-as-a-Service solution fuels growth of new Healthcare Performance Management category
- MedeAnalytics experiences rapid growth, gaining over 700 enterprise level healthcare providers and payers since inception
- Microsoft products and technologies provide a strong foundation for the MedeAnalytics solution
Today’s news headlines are dominated by healthcare costs and quality of service issues – specifically, how to lower costs and improve the quality of care. While it is easy to talk about what it takes to fix healthcare, it’s another matter entirely to actually have a solution that can make a difference toward improving the healthcare system right now.
Improving the healthcare system starts with doing hundreds of little things right. Things like wait times in the emergency room, having the right staffing levels at 5PM or 5AM, obtaining all of the correct information from patients at admittance, or having all of the right information available when audited by government entities. All of this requires capturing and analyzing data to make improvements.
California-based MedeAnalytics is making this happen. For eight years, the company has provided an innovative web-based technology solution for improving the healthcare system. MedeAnalytics is a leading provider of a new category of solutions called healthcare performance management. The company extracts data from the many disparate financial, operational and clinical data sources of healthcare organizations, transforms the data, and presents an intuitive, web-based analytics application that allows clients to easily analyze this information and take action.
Significant IT Complexity Hinders Progress for the Healthcare Industry
The healthcare industry has perhaps the greatest IT complexity and challenges impacting IT adoption of any industry. A combination of unique factors in the healthcare industry make it more complex, including:
- Diversity of Systems – Hospitals literally have dozens of clinical and financial systems. Every patient care department (for example, radiology, emergency, surgery) has equipment and technology that is optimized for delivering the specialized care required of that area. Most of these systems are developed by different vendors and cannot be easily integrated together due to technical complexities.
- Outdated Systems – Many of the billing and administrative systems for healthcare providers and payers are more than 20 years old, making it very difficult to modify or expand the systems.
- Limited IT Support Resources – The healthcare industry is typically under-resourced for IT support compared to other industries. This puts a damper on new technology implementations.
- Regulatory and Compliance Requirements – The burden of coding and billing processes, patient data security, and government reporting requirements are perhaps the greatest in the healthcare industry, requiring a number of technology systems dedicated to this effort.
- Limited Capital Budgets for IT Improvements – IT spending as a percentage of revenue is one of the lowest of all industries. This limits the size and number of new technology initiatives.
- Patient Care Philosophy – Healthcare organizations are understandably slower to adopt new technologies as they do not want to disrupt the delivery of patient care. This slower approach contributes to the aging of technology systems.
All of these factors contribute to the difficulty of overhauling the healthcare system through Information Technology solutions. At the same time, these factors also present an opportunity for innovative companies with the right approach and value proposition. MedeAnalytics has been able to overcome many of these obstacles through its unique Software-as-a-Service solution for healthcare payers and providers.
MedeAnalytics’ Software-as-a-Service Approach Enables Completely New Solution Category: Healthcare Performance Management
In the mid 1990’s MedeAnalytics began as an Electronic Data Interchange (EDI) claims processor, working as an intermediary between healthcare providers and payers. The company was processing millions of transactions and thought that all of the data could produce some useful information if there were captured, analyzed, and delivered in an easy-to-understand manner.
Ten years ago, healthcare analytics was a nascent field. Analyzing financial and operational performance required hiring armies of consultants and IT staff to compile and pour over data for 6-12 months, costing hundreds of thousands (if not millions) of dollars, and the information only provided a snapshot in time. Tracking performance over multiple periods of time was simply out of reach for most organizations.
MedeAnalytics began working on a solution in 2001 to capitalize on this potential opportunity. The company felt that the key to success would be in how the solution was delivered. Given the significant barriers surrounding healthcare IT adoption, especially the variety of systems in use, limited IT resources, and capital budget constraints, MedeAnalytics determined that the best course of action would be to build their offering as a Software-as-a-Service (SaaS) solution.
“The SaaS model is an absolutely perfect model for the healthcare industry. The low upfront costs, predictable monthly cost, and low impact on the IT department provide a very compelling value proposition,” commented Ken Perez, SVP of Marketing for MedeAnalytics.
MedeAnalytics solutions are targeted to both healthcare providers (hospitals, clinics, etc.) and healthcare payers (e.g., insurance carriers, managed care organizations). The solutions essentially help these organizations gain actionable intelligence in the areas of:
- Revenue Cycle – Provides insight into coding, billing, reimbursement, and accounts receivable (A/R) performance.
- Patient Information – Brings real-time intelligence to the patient registration process, including patient payment estimation, charity care screening, risk segmentation and insurance eligibility verification.
- Clinical Operations – Provides daily insight into service line profitability, physician performance, clinical cost drivers and utilization of clinical resources at the patient level.
- Regulatory Compliance – Provides daily insight into clinical quality initiatives and coding compliance risk.
The MedeAnalytics solution provides a particularly strong value proposition in the compliance area. Medicare is one of the primary payers for hospital organizations. Medicare payments are based on documented clinical services which are then translated into standard clinical coding terminology and submitted to Medicare in the form of a paper or electronic claim. If a healthcare provider is found to have inadequate or incomplete documentation to support specific claims, Medicare will reclaim the entire payment for that patient. This can have a very big impact on revenues. MedeAnalytics’ solution helps hospitals understand coding activity to identify compliance risk areas and prepare the organization for an audit. The MedeAnalytics solution provides everything needed to properly document the claim and meet audit requirements – thereby optimizing the healthcare provider’s revenue potential.
In addition to the above, MedeAnalytics’ Software-as-a-Service approach provides healthcare organizations with a number of additional benefits, including:
- Works with Any System or Data Structure – Healthcare organizations have data stored in dozens of disparate systems. The MedeAnalytics solution aggregates any type of data and provides a uniform, easy-to-use view for business and clinical decision makers.
- Rapid Implementation – MedeAnalytics solutions can be fully configured and up and running within 90 days.
- Personalized Data Views – Every user within the enterprise can personalize their data views to focus on exactly what they want, all through a few simple clicks within their browser.
- Low Total Cost of Ownership – As a hosted platform, MedeAnalytics does all the heavy lifting from rapid deployment to data hosting to ongoing support.
Perhaps the most important aspect of the SaaS approach is that it has enabled the fast growth of an entirely new healthcare technology solution category. “Without a doubt, the healthcare performance market would not be nearly as sophisticated if it weren’t for SaaS,” stated Perez.
MedeAnalytics’ SaaS Solution Meets with Dramatic Growth Success
The compelling value proposition of the MedeAnalytics SaaS solution has propelled the company to a leadership position. Since introducing the solution in 2001, the company’s customer base has added many of the largest healthcare organizations in the world, including Cedars-Sinai, Cleveland Clinic, the University of Maryland Medical System, Mayo Clinic, Partners HealthCare, and Blue Shield of California. To date, over 700 healthcare organizations utilize MedeAnalytics solutions, and the list is growing every month.
Customers rave about the solution: “MedeAnalytics is a vital part of our business operations. We have been able to aggregate and normalize data on a common technology platform and dramatically improve reporting cycle time and efficiency. We are continually expanding the use of the intelligence derived from MedeAnalytics,” indicated Keith Eggert, VP of Revenue Management at Orlando Health.
Perez sums up the company’s success nicely: “MedeAnalytics’ value proposition and success are rooted in our healthcare focus and expertise, our robust analytic solutions, and our delivery model, in which SaaS is key, enabling us to deliver a compelling return on investment and exceptional time-to-value to our clients.”
Microsoft Products and Technologies Provide the Platform for MedeAnalytics’ Solution
Microsoft products and technologies provide the foundation for MedeAnalytics’ success. From a robust set of development tools, to a highly scalable SQL database, MedeAnalytics is well served with Microsoft technologies.
“The Microsoft development environment, Visual Studio, is well-integrated with the Microsoft technologies we use and allow us to develop with extraordinary speed. We have achieved good developer productivity by embracing and using the entire Microsoft development suite. Microsoft core software such as Microsoft SQL Server provides good price and performance relative to other technologies we could have selected,” commented David Watson, Chief Operating Officer for MedeAnalytics, and former Chief Technology Officer for Kaiser Permanente.
Founded in 1994, MedeAnalytics delivers healthcare performance management solutions that improve financial, operational and clinical outcomes, with compelling return on investment and rapid time-to-value. For hospitals and health systems, MedeAnalytics provides solutions for the revenue cycle, patient access, clinical operations, staff productivity, regulatory compliance and enterprise performance management. For healthcare payers, the company’s solutions address network management, medical management, pharmacy management, employer reporting and operations management. MedeAnalytics provides on-demand analytics and client services to over 700 healthcare organizations using a hosted, Software-as-a-Service model, which reduces up-front costs and expedites implementation.
For more information visit: http://www.medeanalytics.com
About the Microsoft ISV Incubation Program
The Microsoft Incubation Center Program is designed to ease the commercial, financial, and technical challenges ISVs encounter while adding a service-based delivery application to their business offerings. Microsoft has established global facilities with a set of Gold Certified Partners in Hosting to guide ISVs through a structured series of business and architectural consulting sessions to ensure their business model and applications are ready for service-based delivery.
For more information visit: http://www.microsoft.com/hosting/programs/incubationcenter.mspx
For More Information on Microsoft’s Software-plus-Services Strategy
When you combine the ever-growing power of devices and the increasing ubiquity of the Web, you come up with a sum that is greater than its parts. Software-plus-Services is that greater sum. It all adds up to a commitment from Microsoft to deliver ever more compelling opportunities and solutions to consumer and business customers—and to our partners. Microsoft has vibrant businesses on the desktop and in the enterprise, and is making sizable investments in online services and devices. As these four worlds converge, no technology vendor is better positioned to deliver on the vision of Software-plus-Services. Microsoft has multiple ways to monetize the results through the familiar model of software licensing, offering services by subscriptions, leveraging Microsoft's industry-leading advertising platform or the growing form of micro-payments known as Microsoft Points. And, Microsoft has the world’s largest and most diverse partner ecosystem, which is committed to its role in our strategy.
For more information visit: http://www.microsoft.com/softwareplusservices/