Analytics Decision Support
Recognize and reward value through measurement
Measuring value has taken center stage in the health care debates. Measurement tools provide key information to define and monitor the quality of care, measure health outcomes and develop better evidence and guidance on the appropriate use of medical services. Increased transparency into the cost, quality, and service of health care delivery has become a top priority.
Now, managed care organizations including health plans, provider organizations and accountable care organizations (ACOs), can better manage clinical resources, assess risk, measure quality, and conduct predictive modeling with Optum health care analytics, including the Symmetry® suite of solutions.
Symmetry® EBM Connect®
Make health plan decisions based on industry and evidence-based standards
Symmetry® EBM Connect® from Optum is decision support software that compares medical and pharmacy claim, lab result, and enrollment data against industry best practices for clinical conditions and preventive measures. EBM Connect helps health plans assess provider and patient compliance with treatment standards.
Symmetry® Episode Risk Groups®
Predict health care usage and assess cost
Symmetry® Episode Risk Groups® (ERG®) from Optum is a risk assessment solution that predicts current and future health care usage for individuals and groups. ERG creates individual risk measures that incorporate episodes-of-care methodology, medical pharmacy claims information, and demographic variables.
Symmetry® Episode Treatment Group®
Synthesize key care metrics to evaluate best practices
Symmetry® Episode Treatment Group® (ETG®) is an episode grouper for medical and pharmacy claims. It provides a condition classification methodology that combines related services into medically relevant and distinct units describing complete and severity adjusted episodes of care and associated costs.
Symmetry® Pharmacy Risk Groups®
Measure, understand and prevent threats to member health
Symmetry® Pharmacy Risk Groups® (PRG ®) is a pharmacy-based health risk assessment software that uses prescription data and proprietary classification systems to help organizations understand and measure member health risk. PRG provides risk measures for every individual in a managed population, and helps users make timely predictions regarding people with highest risk.
Symmetry® Procedure Episode Groups®
Symmetry® Provider Cost and Quality Connect
Measure provider and network performance
Symmetry® Provider Cost and Quality Connect (PCQ Connect) is software that delivers a methodology for defining peer groups of physicians. It performs like-to-like comparisons, attributing physician responsibility for specific patients, and risk adjusting for differences in patient morbidity and case mix across providers in peer groups.