Analytic consulting firm specializing in creating analytic solutions for innovative companies in the areas of total population health management, post-acute care optimization, bundled payments, and shared savings contracts.Clients include: CVS Health, Maine Health ACO, Center for Health Information and Analysis, naviHealth, Arcadia Healthcare Solutions, Harmony HIT, Paladina Health, Premier Healthcare Alliance, Indegene Healthcare, Artemis Healthcare, Archway Health, myCatalyst, Good Measures, Caremetrics, Qcentive, Cure Forward, Mile High Health Analytics, Independence Blue Cross, Health Data Decisions, Health Intelligence Partners, TCOhealth, PACCR, Wiser Together.

Mile High Healthcare Analytics provides practical population-oriented analytics to health plans, Exchange issuers, ACOs, and risk-bearing provider groups. Our strategic consulting focus is on risk adjustment operations, performance measurement and improvement, Stars, the Quality Rating System, and alternative payment designs. We provide business process assessments, operational assessments, and feasibility studies– striving to improve the operational performance of our clients.Mile High Healthcare Analytics is also data-focused. Using large and complex datasets of patient-level data from claims, pharmacy, clinical laboratory results, member enrollment, CMS-supplied data files, and supplemental data, we roll up our sleeves to clean and then analyze the data. Our healthcare analytics pay as much attention to the underlying completeness of the data as to the analytic models that are employed. With good data we derive and validate predictive models in clinical, operational and financial areas for healthcare organizations bearing financial or insurance risk. Because we understand data and manipulate it ourselves, Mile High ensures the validity of the results from analytics and the applicability of those results to our clients’ objectives.After we transform and analyze the data, we explain the results and the methods we used to arrive at those results. We are able to explain the data transformations, analysis results, integrated into the underlying public policy context to physicians, CFOs, project managers, medical economics departments, and the IT team. Your Mile High consultant understands applicable regulations, statutes and guidance that govern risk adjustment, performance measurement, and quality improvement for Medicare, Medicaid, and individual/small-group issuers.

The mission of Archway Health Advisors is to fix healthcare through payment reform. As the payor and provider worlds converge, healthcare organizations have a myriad of opportunities to manage care and risk in new ways. Archway works with providers to illuminate these opportunities and to design, execute and finance the care and risk management programs that best fit their capabilities.

 Designed and sold Accountable Care financial return model. Planning tool helps hospital systems, health plans and other organizations anticipate financial impacts from entering into value-based payment contracts. Marginal analysis of impact across the entire health system allows for scenario planning and sensitivity analysis. Owner of Population Group Summary Report, key opportunity analysis product identifying savings and quality opportunities for new and current clients. Used in all aspects of the client relationship, including sales, solution design, consulting, relationship building and upselling. Redesigned product including enhancing analytics, automating table build process, and updating powerpoint design. Leadership and proactive enhancements resulted in key clients retention, multiple sales, and savings resulting from resource utilization reduction.

Senior consultant and research director charged with expanding client base and improving market position of Care Analytics division. Responsible for designing and improving key product lines including predictive modeling, ID and stratification, outcomes measurement and value based benefit design.

Leader of research team that developed methodologies for reporting financial outcomes to clients across all business units and products. Credible medical cost savings estimates identified by external consultants as the key driver of new sales and client retention. Subject matter expert in savings analysis as well as utilization reporting. Recognized innovation and thought leader within the company. Responsible for budgeting, resource assignment, and career development of team of four experienced analysts.

 Customized concurrent risk adjustment model for Medicare “Pay for Performance” demonstration. Evaluated multiple regression methodologies and identified new validation techniques. Authored report outlining risk adjustment process and presented process to potential demonstration participants. Created financial simulation allowing participants to enter individual assumptions and analyze impact on potential bonus payments enhancing user experience and increasing participation rate.Member of proposal teams with over 60% success rate. Key proposal on small area variations awarded from DOD to increase RTIs profile at strategically targeted organization.

Integrated Healthcare Information Services, Inc. develops health care information solutions for national managed care organizations, care management providers, pharmaceutical, and medical device manufacturers. The company provides predictive modeling and information solutions to the health care industry. Its Impact Suite includes predictive modeling tool; performance measurement and decision support; and reporting and analysis tool for employer groups. The company’s products include Impact Analysis, a suite of modules that enable managed care organizations to identify financial, clinical, and operational opportunities; Impact Pro, a predictive modeling and care management analytics solution, which allows health plans to utilize clinical, risk, and administrative profile information, as well as measures and characterizes future health risk for individuals and populations; and Impact Account Reporting, which supports internal business demands and external reporting requirements. Its managed care benchmark database comprises laboratory results data, pharmacy data, mental health data, and balanced line of business mix. The company was founded in 1996 and is based in Waltham, Massachusetts. Integrated Healthcare Information Services, Inc. operates as a subsidiary of OptumInsight.