OPN’s extensive capabilities in oncology claims and care management allows it to provide robust data-driven insights into how that care is administered.
OPN reviews treatment plans in real-time, which provides an immediate understanding of the care being provided. Clinical data captured at the front end helps rapidly identify different supportive measure opportunities for patients including palliative care, hospice and clinical trials. OPN then leverages clinical data and reconciles it with the claims submissions to provide a longitudinal understanding of the patient journey and the true financial impacts of authorizations, giving payers predictability in assessing the true value and impact of their costs.
These real-time reports immediately give a clear understanding of clinical and financial impacts to OPN partners and their internal staff. OPN helps its partners recognize what their current oncology spend is and why, pinpointing potential savings approaches without sacrificing quality of care. Once these efficiency measures are implemented, the system allows OPN to verify quickly that these measures and strategies are successful.
A Flexible Data Model
The advanced data infrastructure that OPN has developed has a flexibility that benefits all parties: payers, providers and patients. It drives stated clinical or quality missions for all healthcare participants, enabling the enrollment of patients into specific programs that assist in improved outcomes and cost-effective treatment. It also allows for bespoke solutions and an evolutionary model that can accommodate many parties, depending on payer approaches and initiatives.
When looking at claims data, OPN analyzes a group’s oncology costs and how those costs break down. Over time, these analytical models can ascertain true opportunities to drive down oncology spend and reduce the total cost of care. In developing these analytics models, OPN is able to determine tangible instances of historical data based on advanced algorithms and will be able to identify indicators that show how an organization’s outcomes can be improved or costs can be lowered. This will assist payers, providers and OPN to have a real handle on all aspects of oncology care.
In addition, this resource can anticipate the incidence of a specific cancer diagnosis in the next year and plan for treatment based on provider treatment patterns. OPN can use the power of predictive modeling to help payers and providers understand the financial impacts of expected caseloads.
It is imperative to provide real-time quality reporting to all partners and to their internal staff, so a clear understanding of clinical and financial impacts is known immediately. OPN furnishes actionable business intelligence so its partners understand their current oncology spend, highlighting potential savings methodologies without sacrificing quality of care. This innovative system allows OPN to verify fairly quickly if any measures that streamline a partner’s workflow are successful. Real-time data is not just a retrospective review of past performance, it is a crucial tool that is used to implement forward-looking initiatives that can reduce inefficiencies and improve care.
Importance of Actionable Intelligence
Both payers and providers welcome the thorough and actionable intelligence that this data reporting gives them. Being able to provide benchmarking feedback to providers is essential. It allows them to understand via a concise snapshot how they are operating compared to their peers. For payers, geographic and demographic data can be enormously helpful for them to know if and why cancer costs are increasing. This is especially important when they are considering the overall cost of care.
Data can often be spotty on patient care, so OPN fills in the data gap by generating detailed reports based on patient claims and the underlying data of the care that a physician provides to patients. In addition, OPN has developed several supportive programs that contribute to the holistic care of patients while also providing important feedback on the patient experience, contributing to a more fully rounded perspective of the patient journey. OPN can furnish payers a significant level of insight and intelligence on a regular basis based on this data.
Care Management Services
Clinical and financial expertise coupled with leading edge technology allows OPN to facilitate sustainable management of resources and ensure excellent oncology care.
OPN feels strongly about expanding clinical trial access for oncology drugs in any care setting. By giving oncology patients a streamlined way to participate in these trials, new and innovative therapies can be utilized that would normally not be available to such patients, especially ones that come from underserved communities.