Systems and methods for assessing and optimizing healthcare administration

Abstract

A comprehensive patient data assessment system and method for use in generating, tracking and analyzing medical data related to healthcare administered by a group of physicians to a specified patient population. The system is operative to track data related to the claims history, case management, pharmacy data, and lab tests/results for each patient treated by each patient's primary care physician preferably through electronic medical records that are accessible over a computer network. The system is operative to generate data indicative of the utilization of healthcare resources utilized to treat each patient within the patient population, as well as ensure that each primary care physician utilizes appropriate codes for each diagnosis and procedure/test administered to each patient. The system further provides for categorization of patients afflicted with chronic conditions that require high-cost care. The systems are exceptionally effective in conserving medical resources, ensuring uniformity in administering healthcare, and achieving optimal patient outcomes.

Dependencies are inferred from the claim text.