Optimize
Identify optimal networks
and services
Identify optimal provider networks and health solutions partners for your member populations—and ultimately find solutions that measurably reduce costs.
Optimize
Identify optimal networks
Create solutions that are custom-fit for your members with Optimize To help you lower healthcare costs, achieve better margins and foster membership growth.
How it works
MacroHealth’s Network Optimization Analysis evaluates past and current solution performance to equip you with an unbiased view of the provider networks and healthcare services that bring the most value and best fit the needs of your specific member population.
Ingest
Historical paid claims are processed, validated and repriced to ensure that personal health information (PHI), personal identifiable information (PII) and sensitive information are either de-identified or removed.
Reprice
Using our repricing algorithms, database and third-party connections, your claims are repriced through the MiX platform across the universe of Health Market Partners that are part of the MiX ecosystem.
Optimize and Design
Machine learning and advanced analytics algorithms will use the repriced claims data from all of the Health Market Partners to develop a set of options for you to evaluate.
Evaluate
Apply various constraints or filters that are specific to your operation or change management requirements. Optimize will present the optimal solution recommendation, demonstrating the resulting financial outcomes.
Operationalize
MacroHealth’s data factory is connected to our interoperability and connectivity solution, Connect, to help you realize the savings identified in the Network Optimization Analysis.
Powerful, Flexible Analysis
The MacroHealth Intelligent ExchangeTM (MiX) platform makes it easy to optimize solutions broadly or granularly, such as by region or group plan, to meet your needs.
Generate all potential combinations and filter out the ones that don’t meet your business requirements to view and compare potential savings for each combination.
Customize Optimization Criteria to Meet Your Business Needs
Granular filtering and logic capabilities ensure you’re not missing out on any potentials savings and selecting a new solution that will best meet your unique requirements
Optimize by Grouping Claims by Multiple Attributes
Enhance healthcare platforms by optimizing claim processing through grouping claims based on multiple attributes, improving efficiency, accuracy, and resource allocation
Compare Multiple Network & OON Combinations
Gain a clearer picture of past and current solution performance to identify partners that bring the most value and best fits the needs of your member population
Leverage Advanced Analytics & Data Science to Guide Business Decisions
Eliminate the need for manual data processing and spreadsheets with the MiX platform.
Systematically analyze and benchmark against data from multiple sources (including your own data, third parties, and vendor partners) to optimize your solutions for cost and quality objectives.
Stay on top of your network’s performance
Use our comprehensive suite of filters and drill-downs to identify trends and take action to improve affordability.
Powerful capabilities that enable you to Innovate:
Data Factory
The Data Factory is a substantial data lake, which includes your data, 3rd party data, and MacroHealth data. This powers your ability to make actionable decisions and get in-depth reporting.
Standard Reporting and Dashboards
Streamline data visualization, promote consistency, enable data-driven decision-making, enhance communication, and simplify performance monitoring for improved efficiency and understanding.
Optimization Engine
Maximize efficiency, resource allocation, and decision-making, leading to cost reduction, increased productivity, and enhanced outcomes in various domains.
Explore the MiX Platform
Optimize
Identify optimal networks and other Health Market Partners through the MiX platform to create your Intelligent Health Market
Learn more
Innovate
Leverage actionable, real-time data insights to gain a competitive edge and grow your business
Learn moreTransform Your Business with the MiX Platform
Experience the power of the MacroHealth Intelligent Exchange platform with a demo. Discover how our approach maximizes Health Market Partner participants, considers your operational requirements, and offers favorable contract terms and pricing. Unlock the benefits of our diverse partner options and tailored solutions for your business.
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