Mike GallagherBut it’s the larger vision of where things are going that has MedeAnalytics’ senior executives so excited about the future. “I think what will transform healthcare over the next decade is analytics; and we live to fulfill that mission,” says Mike Gallagher, the company’s chairman and CEO. “Our gig, so to speak, is the aggregation of disparate data sets, putting them in a hosted model, and delivering them through the web to healthcare executives in a HIPAA-compliant manner. Dr. Fouts, our chief medical officer and a co-founder, calls it ‘data democracy,’” Gallagher adds. “And we work with both providers and payers.”
Bridging Healthcare Sectors
Importantly, the fact that MedeAnalytics bridges the payer and provider sectors in healthcare could well be its strongest calling card, as new reimbursement and care management models such as accountable care organizations, bundled payments, and patient-centered medical homes, emerge under healthcare reform and payer and purchaser initiatives.
Just ask Juan Davila, vice president of provider network management at the San Francisco-based Blue Shield of San Francisco. Over the past few years, Davila has been spearheading private-sector accountable care contracts with several different collaboratives of hospitals and medical groups in Northern, Central, and Southern California (with six live so far), with such well-known provider organizations as Hill Physicians Group, Dignity Health (formerly Catholic Healthcare West), California Pacific Medical Center, and Brown and Toland Medical Group.
“They’re very customer-centric,” Davila says of the MedeAnalytics folks. “I got everything I was thinking about.” What Davila is referring to is his request that MedeAnalytics build his organization a customized, from-scratch, data analytics system for a process to lower the percentage of denied provider claims. That tool has proven to be a wild success, lowering what had been an average 30-percent claims denial rate to a rate under 15 percent, and dramatically improving trust between Blue Shield and the providers in its network.
Meanwhile, on the provider side, Dominic Segalla has equal praise to lavish on MedeAnalytics as a vendor partner. Segalla, senior vice president of Newark Beth Israel Hospital in Newark, N.J. (part of the Barnabas Health system, also Newark-based), has actually been working with MedeAnalytics as a CFO for nearly five years; he began as a customer when he was at St. Vincent’s Hospital in Manhattan, and brought MedeAnalytics with him as a vendor partner when he came to Newark Beth Israel a year ago. Using the company’s Patient Access Intelligence solution, its patient registration software, has helped his organization to significantly improve point-of-registration payer authorization verification, Segalla notes. And he and his colleagues have just started using MedeAnalytics’ revenue cycle solution as well.
