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ANALYTICS AND RISK MANAGEMENT

SKYGEN USA’s Analytics & Risk Management services leverage the healthcare industry’s most sophisticated big data and analytics to delve deeply into the factors that affect cost of care and network performance.

SKYGENUSA Powering Healthcare for the Digital Age

Armed with this data, our team of Benefit Management Analysts develops a customized benefit management strategy to improve efficiency and reduce costs, so clients can efficiently deliver more and better care to members across their markets. Clients spend smartly to improve provider relationships and increase access to care. Every necessary step is covered to ensure health payers receive an improvement plan that is impactful and immediately actionable.

MARKET ANALYSIS

Uncover market-specific opportunities to increase savings and improve program quality.

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BENEFIT plan ANALYSIS

Aimed at optimizing overall benefit spend, SKYGEN USA’s Benefit Plan Analysis examines the market- and plan-specific impact of best-practice strategies which drive cost savings, greater provider satisfaction, and improved employer group experience.

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REIMBURSEMENT MODELS

SKYGEN USA helps payers determine if their reimbursement model(s) are helping to encourage and realize appropriate and efficient care.

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PROVIDER PERFORMANCE

SKYGEN USA’s provider performance ratings are designed to measure the appropriateness and efficiency of care delivered by each provider, enabling payers to reward high-performing providers with increased referrals or higher reimbursements, while reducing and preventing fraud, waste, and abuse.

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FRAUD, WASTE & ABUSE

SKYGEN USA moves the power to reduce and prevent FWA into the hands of payers with AI analytics that identify outliers within the payer’s network.

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