Research and Analysis

StrategicHealthSolutions, LLC (Strategic) provides research and analysis of health care programs, statutes, regulations and guidance, and potential program vulnerabilities to combat program inefficiencies and fraud, waste, and abuse (FWA). Strategic delivers data-driven decision analysis paired with subject matter expertise resulting in actionable outcomes and revealing previously unknown opportunities on a range of topics related to Federal and State health care programs.

Services

  • Customized monitoring of State and Federal legislation, prosecutions, settlements, and social media to develop position papers, briefings, and targeted reports
  • Program and financial risk assessment to determine impact
  • Return on investment and cost-savings modeling to evaluate program effectiveness
  • Statistical sampling for defensible results
  • Overpayment extrapolation
  • Research and expert testimony to support litigation and appeals
  • Advanced analytics in support of program integrity efforts
  • Informed decision-making through consistent information exchange
  • Actionable findings with measurable outputs that mitigate risk
  • Stakeholder collaboration and pilot study management

The Strategic Advantage

  • Program vulnerability detection and risk assessment management
  • Strategic planning and program operations support
  • Transformation of large amounts of data into consumable information
  • Defensible results that withstand scrutiny
  • Accomplish objectives effectively while minimizing risk, controlling costs, and optimizing performance through compliance with the Centers for Medicare & Medicaid Services’ (CMS) Integrated Information Technology (IT) Investment & System Life Cycle (ILC) Framework
  • Predictive analytics, statistical modeling, actuarial analysis, data mining, and  anti-fraud algorithms using SAS®, SQL®, SPSS®, and Business Objects®
  • Data visualization to intuitively convey complex findings
  • Data warehousing, database development, and Extract, Transform, and Load (ETL) capabilities
  • IT system solutions, quality assurance oversight, business analysis, requirements development, and program release management consistent with IT ILC