Risk Navigator Performance

Gain a complete understanding of provider performance

LexisNexis® Risk Navigator Performance employs advanced analytics that identify utilization of cost trends across networks. Users are able to drill down to individual physicians and patient profiles for details on the factors that are driving costs and impacting quality of care.

LexisNexis® Risk Navigator Performance incorporates severity-adjusted provider and network performance analytics that provide input to quality improvement programs and cost and utilization reduction efforts.

Benefits:

  • Accurate analysis of provider contribution to efficiencies and risks by episode through attribution of their roles (PCP, Primary, Secondary)
  • Provider comparisons by peer, ETG and specialty enable accurate assessments across network- or client-defined peer groups
  • Ability to reduce cost and utilization, while improving quality of care, with regard to: admission rates, readmission rates, ER visits, physician visits, radiology costs, laboratory costs, etc.

LexisNexis® Provider Performance Monitor compares individual provider performance to a variety of benchmarks appropriate for their specialty. Severity-adjusting the analytics levels the comparisons to enable a fair view across providers in a network.

Features include:

  • A full 24 months of episode data compiled at national, regional, product line, medical specialty and client-specific levels for profiling purposes
  • Flexible benchmarks, which can be derived from a database of 50 million members of from the client’s own data set
  • Case Mix and Concurrent Risk measurement of the illness burden for a provider’s or a network’s population, to produce a balanced efficiency rating

Contact Us

For more information about our solutions call 800.869.0751 or contact us online

LexisNexis® Provider Performance Monitor does not constitute a “consumer report” as that term is defined in the federal Fair Credit Reporting Act, 15 USC 1681 et seq.(FCRA). Accordingly, LexisNexis Provider Performance Monitor may not be used in whole or in part as a factor in determining eligibility for credit, insurance, employment or another permissible purpose under the FCRA. Due to the nature of the origin of public record information, the public records and commercially available data sources used in reports may contain errors. Source data is sometimes reported or entered inaccurately, processed poorly or incorrectly, and is generally not free from defect. This product or service aggregates and reports data, as provided by the public records and commercially available data sources, and is not the source of the data, nor is it a comprehensive compilation of the data. Before relying on any data, it should be independently verified.

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Did you know?

The JAMA published an article reporting that the most important controllable contributor to the high cost of U.S. health care is overutilization.