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Healthcare cost modelling

Dashboard for Research, Insight, and Validation of Experience (DRIVE)

The Dashboard for Research, Insight, and Validation of Experience (DRIVE™) is a business intelligence tool that provides clients a way to visualize and quickly manipulate their summarized historical experience data in relation to other comparative data, such as pricing information or experience from other time periods or geographic areas. Using a web-based application, users can “slice and dice” data by any of the key dimensions loaded into DRIVE, enabling them to identify outliers at a high level and drill into detailed drivers of the outlier to better understand and take corrective action in a timely manner.

DRIVE is flexible; the tool doesn’t require users to hit a specified data format and is not limited to a specified list of dimensions. This allows for easy acceptance of new data and results in a short implementation timeline and quick turnaround times back to states, health plans, providers, and other partners. This quick turnaround allows all parties to see the impact of ongoing changes for further analysis—which has proven to be especially helpful to our clients when crafting policy decisions.

The DRIVE tool provides client and related party personnel the following capabilities:

  • Compare encounter and/or fee-for-service claims experience at the service detail level across multiple key high level dimensions.
  • Provide a dynamic comparison of multiple data sources at an aggregate level by choosing two data dimensions to split the report.
  • Allow users to identify high-level issues and drill into service level drivers.
  • Line chart functionality allows users to effectively visualize data over time across various dimensions in the underlying data.
  • Bar chart functionality allows users to effectively visualize differences in experience across multiple data dimensions.

DRIVE use cases

  • To validate encounter data. Encounter data is crucial to setting capitation rates, monitoring program effectiveness, evaluating health plan performance, and more. Without complete, up-to-date, and accurate encounter data, it is impossible to have a successful managed care program. DRIVE transforms previously static reconciliations into dynamic comparisons of data with drill-down capabilities, allowing states and health plans to work through encounter data quality concerns using the same information. The DRIVE tool allows states, health plans, and other key stakeholders to view summarized encounter data from the state’s data warehouse as well as the health plan-reported experience.
  • To provide the data book for purposes of health plan procurement or rate setting. By providing the data book in DRIVE, bidders and contracted health plans can quickly understand the managed care program’s historical enrollment, utilization, and cost information.
  • To understand emerging experience. We load emerging fee-for-service and encounter data on a monthly basis into DRIVE for many of our state Medicaid clients so that state Medicaid personnel can quickly understand emerging trends and respond to any questions from health plans or other key stakeholders.
  • To compare to historical fee-for-service experience. A key comparison our state Medicaid clients are interested in when setting up a new managed care program is how the emerging experience compares to the fee-for-service experience. DRIVE provides an effective way to compare metrics across multiple key dimensions. DRIVE has allowed us to help identify areas of concern in the emerging encounter experience in a quick and efficient manner so that issues can get communicated and addressed.
  • To compare to the underlying benefit expense in the capitation rates. Another key comparison our state Medicaid clients are interested in is how the emerging experience is coming in relative to the underlying benefit expense in the capitation rates experience. DRIVE allows us to identify areas where emerging experience is coming in higher than estimated in the capitation rates. Additionally, it helps answer questions from health plans in an efficient manner.
  • To inform policy decisions. DRIVE has provided our state Medicaid clients with the ability to get real-time answers to key questions during policy meetings. DRIVE provides the necessary bridge between policy and data to enable states to make the best decisions in a timely fashion.

In all of these use cases, clients and any other key stakeholders could have access to the data to provide as much transparency as possible and to quickly answer and provide documentation to key questions (related to program, health plan, or provider performance) from stakeholders with its export functionalities and data visualization.

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