Applications, subject matter expertise, algorithms, data mining, and advanced investigation methods.

Benefits

Thomson Reuters uses its decision support applications and advanced data investigation methods to detect and investigate healthcare fraud, waste, and abuse. We help federal organizations use data from health claims and other sources to produce actionable information.

Our products and services include:

Advantage Suite

Integrates information from diverse sources and systems, organizes it to support decision making, and enables easy access to information in a flexible, customized application. Its powerful applications are linked to an integrated warehouse of medical and prescription claims, encounters, eligibility, lab results, authorizations, health risks assessments, and performance measures.

Medical Episode Grouper

The Medical Episode Grouper (MEG) enables government agencies to analyze patient treatments, evaluate quality of care, and manage associated costs. It does so by grouping inpatient, outpatient, and pharmaceutical claims into clinically homogeneous units of analysis called episodes that describe a patient's complete course of care for a single illness or condition. The result is a sophisticated methodology that is used for a wide range of applications such as provider profiling, disease management, quality improvement, and cost and use analysis. Agencies can incorporate MEG into their existing information system, or it can serve as an integrated component of Advantage Suite.

DataProbe

A data analysis and decision support system, DataProbe enables analysts, researchers, investigators, and other knowledge workers to rapidly perform complex, multi-step, iterative investigation on various types of detail data from different sources. DataProbe is primarily used to manage and swiftly analyze large volumes of detailed health-related data to support research, investigation, and decision making. With DataProbe, non-programmers can quickly create and analyze large databases. It is designed for knowledge producers who need to perform exploration and analysis of data patterns without having to rely on a programmer or on someone with special expertise. Clinicians, nurses, claims examiners, healthcare and research analysts can all build databases that enable them to efficiently integrate and access large volumes of claims detail, eligibility, administrative, discharge abstract, vital statistics, survey, workers’ compensation, absence, short-term disability, welfare, external benchmark, census, birth records, UCR, and other similar data, without needing to burden the IT department or other intermediaries.

Consulting Services

Thomson Reuters has the knowledge, the resources, and the consultative experience to help government agencies balance the cost and quality of healthcare within the constraints of the fiscal environment. Our experience with multiple federal agencies enables us to provide unique insights for addressing specific program needs. Our benchmarks help agencies better identify opportunities for program redesign and improvement, while our proven clinical and analytic methods ensure the information is reliable.