Systems and Methods of Analyzing Healthcare Data

A computer readable medium comprising a computer program recorded thereon that causes a computer to perform the steps of:

• providing a graphical user interface;
• displaying data for admissions to a health care facility for a plurality of health care plan members;
• identifying a condition for the admissions of the plurality of health care plan members;
• identifying a disease management program addressing the condition;
• displaying an enrollment status in the disease management program for the plurality of health care plan members;
• and
• identifying a non-enrolled portion of the plurality of health care plan members that are not engaged in the disease management program.

A method of evaluating data for utilization rates for health care providers, the method comprising:

• obtaining data for utilization rates for a plurality of health care providers;
• determining a normal range of utilization;
• identifying a subset of the health care providers with utilization rates that are within the normal range of utilization;
• and
• identifying a subset of the health care providers with utilization rates that are outside of the normal range of utilization.

A computer readable medium comprising a computer program recorded thereon that causes a computer to perform the steps of:

• providing a graphical user interface;
• displaying data for utilization rates for a procedure for a plurality of health care providers;
• displaying a normal range of utilization;
• and
• identifying a subset of the health care providers with utilization rates that are outside of the normal range of utilization.

A method of identifying an opportunity for an improvement in a health care plan member's quality of health coupled with a medical cost reduction, the method comprising:

• reviewing real-time data for admissions to a health care facility for a plurality of members of a health care plan of a client;
• identifying a subset of the plurality of members of the health care plan, wherein members of the subset were admitted to the health care facility with one or more conditions;
• identifying a disease management program addressing the one or more conditions, wherein the disease management program is not currently purchased by the client;
• notifying the client of the subset of the plurality of members of the health care plan that were admitted to the health care facility with the one or more conditions;
• and
• notifying the client of availability of the disease management program.