Healthcare

    Improving access and quality to achieve a healthier, more affordable future

    CVP’s Health Solutions

    As new technologies emerge, cost and access to healthcare changes. In our work, we leverage the right data to drive continuous service improvement through better customer insight, allowing CVP to optimize organizational performance. Our business and technology consultants help private and public health care clients improve access to quality, affordable health care through analytical and consulting solutions that improve beneficiary services, claims processing, program rollout, training, and performance analysis of research and payment demonstrations.

    We combine our experience in Medicare, Medicaid, and private insurance to help our clients:

    • Reduce beneficiary frustration through contact center call accuracy and efficiency solutions
    • Prepare their internal systems to comply with provisions of the Affordable Care Act and Medicare, and anything that the future holds
    • Improve enrollment in health programs through outreach and education
    • Connect and analyze data from disparate systems to improve decision-making
    • Develop analytical test beds to assess the impact of new value-based payment programs
    • Design solutions to prevent fraud

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    Representative Projects

    Improving Performance Metrics and Analytics on Healthcare

    State agencies manage billions of dollars of Medicaid funding. They may explore alternative models of service delivery and financing. These demonstrations exceed over $100 billion annually. CVP has delivered a cost-effective Medicaid data analytics platform that streamlines data collection, tracks performance-based incentive payments, and produces analytical reports. It is open-source and 100% cloud-hosted. Medicaid uses this platform to monitor the program, carry out policy research and objectively evaluate if the state experiments are producing the expected results.

    Finding the Analytical Keys to Improving Healthcare

    Medicare and Medicaid are shifting the federal healthcare system toward a quality strategy to optimize health outcomes by leading clinical quality improvement and transformation through select programs. CVP leads the data analytics and ad hoc reporting efforts to support this initiative. The program handles several terabytes of healthcare quality and related data spanning billions of healthcare records from multiple data sources. CVP performs data extraction, harmonization, complex data analytics services, and applies big data technology to answer key reporting, oversight and research questions.

    Streamlining Research Oversight Systems

    An agency performing oversight and advice on research and compliance matters, including the ethical use of human subjects, laboratory animal welfare, research safety protocol, privacy and information security, and research misconduct, in a major healthcare organization. The legacy system was a dead-end application that could not satisfy case management needs of researchers in laboratories or oversight personnel. CVP designed and delivered a new case management solution that could adapt to the work flow requirements and expand to cover new needs.

    Tracking Down Fraud, Waste, and Abuse in Healthcare

    CVP provides Medicare with data analytics services to tackle risks and vulnerabilities related to participant compliance and fraud, waste, and abuse (FWA) in the Medicare’s Innovation Center models. These offer the promise of improved performance. However, they may not fit standard preventive and corrective measures for potential FWA. CVP teams develop evaluation reports and recommendations to identifying payment, usage, and billing patterns that may point to FWA, vulnerabilities, or noncompliance. Recommendations help Medicare develop procedures for its Fraud Prevention Program.