Driving revenue and cost savings with advanced data tools: Meet MGMA Analytics

Your day-to-day pain points — finding ways to cut costs, retain or add staff and manage claim denials — require actionable insights to make your revenue cycle more efficient. Artificial intelligence (AI) and machine learning (ML) sound promising, but most healthcare leaders are unsure where to start or how to determine an ROI for these new tools.  

To help you drive revenue and identify cost-saving opportunities, MGMA has partnered with the experts at WhiteSpace Health to build  MGMA Analytics, an advanced analytic SaaS platform that offers real-time, actionable insights tailored to your needs. Automating analysis tasks gives you back the precious commodity of time. We have built an all-in-one platform to save time, combat staffing issues, increase collections, all while improving patient access.  

How does MGMA Analytics work?  

MGMA Analytics simplifies the complex, multi-source data you have and provides easy-to-follow dashboards and reports for a holistic view of your revenue cycle and daily operations. making advanced data analytics a breeze for practices of all sizes. 

Actionable insights derived from your data are ready to use, in a precise visual format, that even new hires can understand. We know how hard it is to hire and retain skilled members of your RCM team. Leverage ML to make data-backed profitable business decisions.  

Example: Denial management — ML will show you what A/R is recoverable and prevent your team from wasting time reworking claims that will not bear fruit. You can quickly see claims against timely filing, high dollar amount, A/R that shows the best path to resolution.  

Unless you have a fully staffed team of expert analysts, you are likely losing revenue that should be yours. Advances in AI and ML have revolutionized the healthcare revenue cycle. Payers are capturing untold dollars of technology to issue more denials and underpayments. Just ask them.  

There are four types of analytics, all of which your teams should leverage:  

1. Descriptive analytics: Uses past data to make sense about patients, denials, staffing, etc. 
2. Diagnostic analytics: Finding the root cause within the patterns of data.  
3. Predictive analytics: Uses insights from current and historical data to forecast what is going to happen in the future. 
4. Prescriptive analytics: Gives your practice recommended next steps to follow based on the analyzed data. Clear, precise, actionable insights that lead to increased revenue! 

Our team of experts will map, cleanse and sort your siloed data from disparate sources and track key datapoints from beginning to end. You will make the most of your collected data and upskill your current EHR and PM systems.  

How will MGMA Analytics increase revenue?  

Too many healthcare leaders were promised that their EHR system would take care of analytics — promises that have gone unfulfilled in large part without purchasing add-ons from the vendor or searching for bolt-on applications.  

Thankfully, today’s SaaS platforms can work with your system to surface actionable data from multiple sources, process it, automate analytical tasks, export reporting and accelerate decision-making. 

• Descriptive analytics: Historical data is a goldmine! We can see trends and patterns by past actions and ML will provide feedback on how to correct root cause issues. You can now learn from the past and enhance decision making, improving your bottom line.  
  • Business intelligence tools can be time consuming and burdensome. Tableau, Power BI, Google Analytics are great tools, but require human power to keep working. We have a solution built for success that offers industry-leading implementation turn times so you can stop wasting time and money attempting to recreate the wheel. 
• Diagnostic analytics: Overspending on finding the root cause of your data trends is a waste. Let the experts do their magic. With combined decades of RCM experience, the MGMA/WhiteSpace Health team has built a solution that leverages diagnostic analytics and data mining to interpret metrics and make sense of the “why” behind the data.  
  • Let ML save you hours by scanning through historical data and finding patterns to correct in the future.  
  • You collect terabytes of data and have been for a long time. Put that historical data to work! By using ML algorithms, trends and patterns based on your past actions can be analyzed to create future successes.  
  • Example: You may see that a CPT® with a modifier is denied and then paid. By finding the root cause and changing future code, you’ll increase clean claims. 
• Predictive analytics: This is a crucial step in your analytic journey that will help project future results based on historical and current data. Your decision makers can create data-backed forecasting models. By leveraging ML models, you can make informed decisions for future success in your revenue cycle and daily operations. 
  • Find gaps in provider schedules  
  • Find past coding trends and make corrections 
  • Predict patient access issues and allocate resources accordingly 
• Prescriptive analytics: You have mountains of data, now what? Leverage the power of prescriptive analytics to receive actionable insights from your data that will guide you through next steps. 
  • Be shown (step by step) how to reprocess denied claims. Using historical successes, ML will provide canned responses. Your team will be shown what claims to reprocess. 
  • Do not waste time on claims that will not be paid. 
  • Work claims in bulk and increase bandwidth. 
  • This is the future of your revenue cycle — the “Aha!” moment. 
• Combat staffing/talent shortages 
  • The engineers behind MGMA Analytics have decades of on-the-ground experience and have created a platform that does that hard work. 
  • Hire from a less experienced or non-experienced talent pool. 
  • Reduce clicks to get relevant information. User-friendly dashboards are easy to navigate and offer more intuitive ways to digest the data. 
• Cut operational costs 
  • Use analytics to make sure you are staffed correctly. 
  • Allocate company resources in the most efficient manner. 
• Streamline workflows 
  • Use ML to monitor credentialling issues, missing charges, claims stuck in edits, cash dips/ charge dips, even a coding scorecard 
    • Sort data with drill downs by location, specialty, physician, resource and timeframe. 
  • Speed up cashflow with efficiency trackers. 
    • Monitor A/R not touched for five days, or claims touched over five times without a resolution. 
    • Proactively work potential denials by adding medical records or a recommended modifier.  

The end goal is to normalize all data from disparate systems and create standardized reporting areas across previously challenging areas, helping us make significant strides in understanding system-wide opportunities. We understand that as a healthcare leader, you want technology to augment your team, not dehumanize them. Schedule a meeting to discuss adding MGMA Analytics to your practice and let us help you empower your staff with the right tool for successful outcomes. 

Your MGMA Analytics team looks forward to being your trusted partner in advanced analytics, striving to help you achieve your highest profitability in a long time.