• • Which diseases are likely to be most prevalent and most costly for this patient population;
  
  • What's unusual in expected disease incidence and costs for this population; and
  
  • Whether costs for each disease are being driven by high-cost individual cases or high incidence.

Physician Groups, Hospitals and Other Health Care Providers can use this information to:

• Evaluate Contracts. Examine the disease patterns and costs expected from each major contract. Strategize which contracts to keep, renegotiate or terminate;
• 
  Negotiate Better Contracts. Show the impact of adverse selection and negotiate contracts that fairly compensate for the patient population's disease burden;
• 
  Avoid Contract Disasters. Assess proposed reimbursement based on the strength of network in handling anticipated disease patterns in the group to be covered;
• 
  Cut Medical Costs. Prioritize and direct disease management and case management efforts for greatest impact;
• 
  Simplify Compliance. Comply with NCQA and employer coalition mandates for risk assessment;
  
  Strengthen Physician Network. Plan physician and professional staffing based on expected disease patterns;
  
  Compare Actual to Expected Incidence and Costs. Identify possible undertreatment/ overtreatment and inadequate reporting; eliminate cost variances based on selection to focus on genuine medical management issues.

For more information and a sample report, call Strategic Health Resources® at (818) 952-5130.