Eliminate revenue leakage. Billing process and protocol complexity has gone through the roof. Inevitably, omissions, errors, and duplications creep in. Simple rules-based models, plus human review of a sample of bills, are commonly used for triage, but these methods leave money on the table.

Opera's Revenue Leakage Reduction Solution takes a different path, with advanced clustering algorithms that create a group of similar diagnoses, treatments, and charges. Powerful anomaly-detection models identify invoices that look unusual, and pinpoint specifically what's missing. And our learning models continuously improve over time. Altogether, it's a new and powerful protocol. For our client hospitals, in fact, we've identified leakage of up to 2% of their total revenues.

Improve performance. Large chains of hospitals and other care facilities need up-to-date information on what's critical. For instance, they must monitor individual physicians' admissions and referrals, and take proactive and timely actions to keep relationships healthy. They also need a dashboard to track the performance of critical departments, such as ER and specialty areas, across the enterprise. And ways to track key metrics across different hospitals with fair, comprehensive comparisons.

Opera's Performance Accelerator for Healthcare constantly monitors vital information flow across the entire enterprise, providing an integrated view of performance to desktops and mobile devices. For example, through cutting-edge longitudinal pattern recognition and predictive analytics, the Performance Accelerator identifies fading, admitting, and referring physicians long before they actually attrite. Then, it presents a prioritized list with specific actions to keep each physician relationship in tip top shape.

Reduce spending. Healthcare providers spend billions on everything from devices to paperclips. Opera's powerful Spend Intelligence Platform delivers granular, ongoing visibility into your core direct and indirect spend categories, including hard-to-manage physician preference and pharmaceutical areas. We can help you capture significant and rapid savings (typically, 7-15+% in many common spend categories in 4-6 months).

Optimize staffing levels. Your clinical staff is your most valuable asset — and it's also your most expensive, accounting for up to half your operating costs. Yet you may be giving it less attention than it merits, because you see it as a fixed cost driven by very-hard-to-predict census levels.

It doesn't have to be that way. Today, modern hospital systems capture a host of information about patient volume and acuity that can be used as inputs into powerful predictive models. Our models are up to 40% more accurate than those that use historical volume averages. Our Staffing Optimizer then translates arrivals into optimal staffing levels, generating savings of up to 25%. Our solutions also yield lower wait times, better patient care, and more satisfied staff.

Maximize collections. Collections can be a large problem for hospitals and other health services providers, but our Collector Workstation can help. We score each individual dynamically on his or her ability to pay AND willingness to pay, using a wide range of the most up-to-date consumer information available. Then, our account-level collections model will provide specific guidance to each collector on the timing, channel, frequency, and relative priority of each patient communication — brought right to the desktop in an easy-to-use interface. We also use advanced analytics to help maximize payment collection from insurance companies and optimize performance of multiple collection vendors.

Take preventive action against fraud. The Opera Solutions team has a track record of success in delivering pioneering capabilities to address healthcare fraud, waste, and abuse going back over a decade, servicing clients in Medicare, Medicaid, and commercial settings, focusing on medical, pharmacy, and dental activity. Our view: despite many efforts and approaches, fraud remains a $100B problem in healthcare. We think it needs a different approach, applying financial institutions' methods to the healthcare space. Think of it: almost every financial transaction is scored in real time for fraud risk. We can apply the same approach, using our powerful fraud and anomaly detection models to score medical transactions for overpayment risk, so you can identify problems early and minimize pay-and-chase.

Improve adherence and outcomes. Opera's Adherence Solutions analytics can help identify patients most at risk of not adhering to prescribed treatments, and then deliver adherence "Touch Curricula" — a set of individuated, ongoing communications tailored to each patient's particular behavioral, clinical, and financial needs. What's more, our cost/benefit optimization models ensure that case management resources are deployed efficiently by prioritizing cases and assigning them appropriately.