Solomon J. Zak, MD Vice President, Business & Medical Intelligence ikaSystems Corporation

Network Optimization Using Business and Medical
Intelligence to Enhance Quality and Cost of Care

In any successful and comprehensively managed health care
system, it is essential to appreciate relationships between primary
care physicians (PCP), specialist networks, and the implementation of
realistic and cost effective programs such as disease based
management and pay for performance (P4P). Cost effective health
care is synonymous with high-quality care and the relationship
between the two is synergistic.

ikaSystems provides a web-based Business & Medical Intelligence
(ikaBMI) solution that leverages its Provider Utilization Management
Systems for PCPs, specialists, and utilization management staff
members to implement various programs. These systems include the
analysis for cost and quality of care considerations in healthcare
network management, yielding intelligence that is particularly
valuable to the CEO/CFO.

ikaSystems will distribute profiling and utilization management data
and analysis of groups and providers in several longitudinal studies;
along with statistical data showing the case mix adjusted evaluation
of providers and practice patterns through web-portals for providers,
employers and utilization management staff, and how they can be
used, e.g. for provider selection as it relates to the establishment of
tiered networks based on P4P.

Attendees of this session will receive the results of more than
thirteen years of statistical data analysis from leading health plans
which will show the impact primary care physicians have had on the
specialist networks and highlight how only reliable and valid case mix
adjusted evaluation of practice patterns of individual primary care
and individual specialist providers will yield the needed results.