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MCC: Quality Services to Boost ROI
Mark S. Rivera, MPH, CHTS-IM, President , MCC
Oftentimes, analytics experts and executives of a healthcare organization are unable to communicate effectively as each uses their respective jargon. Mark Rivera, President at MCC, says, “Advanced analytics has become the newfangled entrant in the conference room, helping executives address their organizational pain points. However, harnessing its power demands high levels of competence, and patience.” With this being the scene, it becomes essential to “bridge this gap,” in order to unleash the potential of analytics. This is exactly what MCC does. “We bring graphic representations of the discussions to executives, and then draw a relation as to how analytics can address their challenges.”
Following their mission to “deliver quality healthcare services with a measurable return on investment,” MCC has been engaging with healthcare organizations on a broad spectrum of projects. “Through our network of associated consultants, we bring over 100 years of experience in technical support to meet the needs of healthcare enterprises nationally,” states Rivera.
Since 1996, MCC has been providing technical assistance to payers and providers in managed care programs. Working with a team of healthcare analytics experts, MCC carries out quality processes to define, understand, evaluate, and prepare, data prior to engaging in modeling and deployment. The aim is to measure key performance indicators and answer specific business decisions while reducing the time spent on data mining. They often work from disparate datasets that are merged together. In this process, they sort out the dependent variables and identify the independent variables that act as “predictors.”
We bring graphic representations of the discussions to executives, and then draw a relation as to how analytics can address their challenges
Through deployment of statistical models, MCC determines the most suitable algorithms that can boost accuracy, and enhance decision making for its clients. Finally, MCC tests its models to ensure they actually work, as Rivera explains, “It is an iterative process and the initial findings are not necessarily the final results.”
Among MCC’s many satisfied customers is an east coast Primary Care Association representing nine community health centers. They partnered with MCC to analyze the risk and reward when considering a business offering. Through an analysis model, MCC questioned the actuarial soundness of the model, and realized the potential for downside risk as health centers were obligated to provide services beyond their scope. As a result, negotiations ceased, and the contract was not signed. “We helped avert a potentially catastrophic situation that could have left patients without care and health centers with bad debt,” adds Rivera.
As future endeavors, MCC will continue building on relationships with managed care organizations and provider entities by offering them consistently high quality support. Analytics brings a new dimension to enhancing quality in healthcare through the application of machine learning algorithms. MCC’s next line of innovation is centered on harnessing this particular technology complemented by its deep understanding of the industry. Additionally, the firm is working toward applying analytics to population health management. “We aim to expand the universe of data we analyze including that which addresses what happens to the patient between doctor visits. These are often referred to as “social determinants.” Hence, it is critical, for example to identify the many independent variables that influence a patient’s adherence to their drug regimen.” MCC is also currently building a financial model to measure and boost ROI for healthcare organizations engaging in population health management.
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