HSI assists insurers, universities, consultants, government agencies and others in transforming data into information of strategic value. HSI Networks specializes in health systems analysis of large databases using an innovative mix of technical and health care marketplace expertise. Key areas of expertise are:
- Federal Policy Development and Government Program Evaluation
- Analytics Research including, Economic Modeling, Comparative Effectiveness and Actuarial Analysis
- Healthcare and Insurance Program Evaluation including Cost Benefit Analysis
- Data Capacity
- Advisory Services
1. Federal Policy Development and Program Evaluation
Federal Policy Development
Understand the Policy Environment:
We bring a comprehensive understanding of the healthcare system and provide a framework of the full impact of policy developments on clients’ interests. (Awkward – just feels like a word is missing)
- Conceptualize Meaningful Change:
- We work closely with clients to identify creative solutions to address their policy and business needs.
- We are well-versed in federal statutes and can craft legislative language to carry out policy proposals.
Help Explain the Policy:
- We work with clients to articulate the rationale, goals, and specific proposal details to diverse policy audiences.
Government Program Evaluation
We have extensive experience in conducting evaluations of federal and state government programs including Medicare, Medicaid, Veterans Administration, state and county programs.
Policy Analysis and Modeling
- Analyze CMS provider payment methodologies
- Evaluate financial and operational impacts of proposed policy changes
- Study quality performance measurement and pay-for-performance programs
Program Design and Evaluation
- Design Medicare risk and incentive programs
- Develop and evaluate Medicare, Medicaid and other government demonstration programs
- Assess payment integrity
- Evaluate beneficiary utilization and satisfaction
- Design, deliver, and evaluate provider education and training
- Conduct feasibility and cost/benefit studies
2. Analytics Research including Economic Modeling, Comparative Effectiveness, and Actuarial Analysis
Understand the Research Environment: We provide expertise in a variety of analytic research activities to meet the clients’ needs.
Perform analysis of how CBO, OMB, and CMS would score potential legislation and clarify the basis for CBO/OMB/CMS scores of existing legislation to support legislative strategy efforts.
Use a variety of data sources to determine and execute the best method to highlight economic benefits of clients’ new and existing technologies, tailored to key stakeholders.
Review claims data to provide an understanding of national, regional, and local payment rates for relevant products and services; evaluate the impact of payment policy changes; and provide a foundation for efforts to obtain changes in payment rates from public and private payers
Evaluate the impact of changes in federal, state, and local policy on a company-wide or product-specific basis and determine how to optimize company business objectives under new policy imperatives.
Cost savings/impact analysis
Prepare estimates of the costs and savings associated with existing programs and potential new initiatives. These estimation projects encompass an array of issues including reimbursement options, coordinated care initiatives, benefits design, program eligibility design, taxation, and alternative approaches to performing
Comparative Effectiveness Research
Use data sets and registries to conduct various analyses:
- Perform data analysis, including of linked data sets and electronic health records
- Provide tools for analysis of longitudinal health outcomes for treatment effectiveness
- Perform Services to conduct and manage Institutional Review Board approved comparative trials
- Provide CER technical assistance, CER knowledge transfer and consulting on CER methods and policies
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3. Healthcare and Insurance Product or Program Design and Evaluation including Cost Benefit Analysis
Understand Healthcare and Insurance Environment. We have extensive experience working with healthcare organizations, insurers, medical manufacturers, pharmaceutical companies and others
Program Evaluation: We provide expertise to assist client in all aspects of program development, evaluation and publication of program results.
Feasibility assessments clarify the program logic and outcome expectations of key program stakeholders, leading to a clear description of program target populations, inputs, outcomes, and metrics for measuring and evaluating program performance.
Formative evaluations guide early implementation decision making to fine-tune strategies for engaging program participants and delivering program services and activities.
Implementation evaluations may provide a detailed understanding of the demographics of program participants, the context in which the program operates, the specific services provided, and the processes used for service delivery, as well as the program outputs and short-term outcomes including client satisfaction.
Impact evaluations seek to establish a causal link between the program or policy under study and the outcomes experienced by program participants, either for the program as a whole or for specific subpopulations. Such impacts can be linked with program costs to establish the benefit cost of a program from a variety of perspectives.
Cost-benefit studies examining whether the economic benefits of providing a service outweigh the economic costs of providing that service. Cost-benefit studies are often conducted in conjunction with impact evaluations
Cost Containment Analysis
Cost Containment Analysis is analyzing provider or patient/ enrollee initiatives for the program as a whole or specific interventions o determine if the program objectives are met.
- Analyze initiatives to manage chronic care
- Examine the impacts of consumer-directed initiatives to reduce utilization
- Evaluate effects of incentives to influence provider and patient/ enrollee? behavior
- Assess regulatory policy
Assessments of Program outcomes to determine viability of publication in a professional journal.
4. Data Resources and Capacity
HSI Network specializes consulting in health systems analysis of large databases. We bring gigabytes of mainframe-based health insurance claims databases to the PC level using an innovative mix of technical and health care marketplace expertise. HSI saves the client valuable time and funds by pre-processing large complex data sets into streamlined elegant information systems. Data Capacity includes:
- Medicare & Commericial Procedure Diagnosis and Drug market scans.
- SAS on HIPAA compliant servers with capacity for six terabits of data.
5. Advisory Services
We also provide advisory services in the following areas:
Market Research and Opportunity Analysis
Examination of new market opportunities, including analysis of market size, competitive dynamics, operational success factors, and gap between operational success factors and company capabilities.
Development of strategic planning materials to explain and guide client responses to new business opportunities and policy developments.
Analysis of Federal and State Laws and Regulations:
Analysis of federal and state laws and regulations, and ongoing policy debates that will shape new market opportunities and/or impact a client's strategic planning processes and general business activities.
Business Due Diligence
Analysis of the political, reimbursement, and business environments that help to define the attractiveness of potential client acquisitions and venture capital investments.