Clinical Cost Intelligence

1. The Challenge

Details

2. Our Approach

Details

3. Benefits

Details
Technical

The Clinical Cost Intelligence application provides actionable clinical opportunities with each clinical service line at the hospital using AI-driven analytics and detailed clinical improvement plans. Traditional costing methods like RCCs and RVUs often obscure true clinical costs, making it difficult to identify inefficiencies or manage resources effectively. Our method ties real costs—such as labor, supplies, equipment, and clinical time—directly to patient-level activities and outcomes. By integrating data from EMRs, general ledgers, surgical logs, and billing systems, Clinical Cost Intelligence builds a comprehensive and accurate cost model.

AI and machine learning are used to identify high-impact variation, surface standardization opportunities, and recommend changes that reduce waste while maintaining or improving clinical outcomes. Insights are delivered through user-friendly dashboards designed for clinical and operational leaders, enabling lasting change through physician engagement and service line alignment. This approach empowers health systems to reduce expenses, improve margins, and support value-based care without compromising quality.

The Challenge

Health systems that have acquired ambulatory care practices—and independent ambulatory practices alike—face tremendous financial pressures and challenges to financial sustainability. If you’re an ambulatory care leader, you’re looking to improve the efficiency of the services you provide and find cost savings without negatively impacting patient outcomes, the community, or the integrity of the organization. Yet it can be difficult to access data that brings actionable insights to inform decisions to improve patient access, panel management, provider productivity, referral management, or quality scores.

Our Approach

The Clinical Cost Intelligence application provides actionable clinical opportunities with each clinical service line at the hospital using AI-driven analytics and detailed clinical improvement plans. Traditional costing methods like RCCs and RVUs often obscure true clinical costs, making it difficult to identify inefficiencies or manage resources effectively. Our method ties real costs—such as labor, supplies, equipment, and clinical time—directly to patient-level activities and outcomes. By integrating data from EMRs, general ledgers, surgical logs, and billing systems, Clinical Cost Intelligence builds a comprehensive and accurate cost model.

AI and machine learning are used to identify high-impact variation, surface standardization opportunities, and recommend changes that reduce waste while maintaining or improving clinical outcomes. Insights are delivered through user-friendly dashboards designed for clinical and operational leaders, enabling lasting change through physician engagement and service line alignment. This approach empowers health systems to reduce expenses, improve margins, and support value-based care without compromising quality.

Benefits

  • Accurate, actionable cost insights. Delivers true patient-level costing using activity-based methods, enabling precise understanding of clinical cost drivers.
  • Reduction in clinical variation. Identifies and supports standardization opportunities that reduce unnecessary variation without compromising quality.
  • Data-driven physician engagement. Equips clinicians with trusted, evidence-based data to drive adoption of cost-saving initiatives.
  • Improved operating margins. Uncovers targeted savings in supply, labor, and service line operations to improve financial performance.
  • Support for value-based care: Aligns cost insights with outcomes to meet the demands of at-risk contracts and reimbursement models.
  • Rapid, sustainable ROI. Enables quick implementation and continuous improvement through embedded AI and real-time analytics.

Proven Outcomes

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