Outsourcing and information technology-enabled services
Our experts bring together a deep understanding of
Regulatory environment
Public policy
As a technology-enabled firm, Livanta provides leadership to federal and state healthcare agencies delivering tangible, innovative solutions that offer exceptional value to all customers and their stakeholders.
Quality Improvement Organization
Livanta’s physician reviewers conduct medical record review by following Medicare medical review standards for various beneficiary appeals related to the cessation of services, such as hospital discharges, termination of skilled nursing services, and other beneficiary appeals.
Value Proposition
The application of medical expertise to Medicare beneficiaries' concerns provides for knowledgeable and fair assertion of Medicare beneficiary rights under Medicare.
Physician review of related medical records for evaluation of Medicare beneficiary concerns about the quality of care they receive is accomplished following Medicare medical review standards.
Value Proposition
The application of medical expertise to Medicare beneficiary concerns about the quality of their healthcare supports the maintenance of quality care by the Medicare Program by ensuring high quality care.
Livanta's Medical Claim and Review Audit services offer data analytics in support of the CMS quality initiatives. These services fuel continual process improvement in Medicare healthcare across quality, cost, effectiveness, and coverage.
Value Proposition
Livanta's processes and systems support the right care at the right time and for the correct cost across Medicare using effective analysis of claims data and medical documentation.
Livanta's Immediate Advocacy services empower the beneficiary and caregiver by hearing, engaging, and helping them. The result is rapid resolution of obstacles and improved healthcare outcomes. Livanta has helped the Centers for Medicare & Medicaid Services (CMS) reduce hospital readmissions by more than 80 percent and improve beneficiary satisfaction.
Value Proposition
When Medicare beneficiaries and their caregivers are heard, healthcare outcomes improve, satisfaction increases, and hospital readmissions are reduced.
Program Integrity and Peer Review
Livanta’s Utilization Review services provide quality review of care across various levels and stages of healthcare.
Value Proposition
When evidence-based standards of care support the level of healthcare provision, the outcomes are idealized as the cost of care is reduced.
Livanta’s Payment Accuracy Review services address healthcare claim analytics, coding validation, medical record review, quality of care review, error rate evaluation, and validation of improper payment determinations.
Value Proposition
Payers, providers, and beneficiaries all benefit from properly documented and submitted claims. This means less work for providers, increased savings for payers, and more satisfied beneficiaries.
Livanta’s Performance, Compliance, and Financial Audit services address healthcare across clinical, statistical, accounting, and administrative disciplines. These services ensure healthcare metrics conform to expected standards.
Value Proposition
Agile support and confirmation of evidence-based healthcare that is documented, coded, and claimed properly improves healthcare outcomes.
Livanta’s Standard of Care and Peer Review services ensures optimal healthcare provision through successful quality improvement and stakeholder interactions.
Value Proposition
Working with providers, beneficiaries, and other healthcare stakeholders serves to provide for continual improvement in healthcare outcomes, including optimal health, avoided complications, and reduced cost.
Livanta’s Error Rate Measurement and Validation services offer health plans and related stakeholders practical experience with error rate workloads, including validating measured errors.
Value Proposition
Through accurate recognition of payment errors, Livanta contributes to the necessary efforts to pay healthcare claims properly.
Data and Analytics
Statisticians at Livanta are healthcare data experts with years of experience selecting the optimal sample size and methodological approach to answer questions about the Medicare population, to determine the total number of clinician audits that need to be conducted, and to assess the effectiveness of statewide health policy. Statistical approaches include randomization, stratification, clustering, and convenience sampling. The goal of statistical sampling is to minimize the margin of error in estimation while maintaining reasonable sample size.
Value Proposition
When data collection is costly, such as with auditing or medical record review, identifying an adequate number of cases is essential to promote a high degree of confidence in the findings while efficiently utilizing resources and minimizing disruption in provider practices.
The Livanta healthcare analytic team provides its extensive expertise in econometrics, statistics, and clinical healthcare to help government agencies decipher trends in health care improvement, identify key insights into program changes, and delineate healthcare impacts of policy decisions. As modeling experts, the Livanta Team navigates Medicare claims, medical record review outcomes, and other administrative healthcare data with advanced statistical techniques to analyze the effectiveness, efficiency, and equity of national and state healthcare systems and to assist government agencies achieve their goals. Our experience modeling healthcare data applies continuous and discrete dependent variables using quasi-experimental, cross-sectional, longitudinal, clustering, and hierarchical/multi-level approaches.
Value Proposition
Unlocking the incredible power of large clinical and healthcare claims datasets fuels understanding and predicts the impact of policies and programs on populations, such as Medicare beneficiaries, while controlling for socioeconomic and demographic variables.
Quantitative analysis utilizes mathematical and statistical approaches to identifying and evaluating measurable data: healthcare data such as direct medical costs, inpatient mortality, 30-day readmissions, and hospital market share and population data such as demographic social determinants of health. Livanta’s quantitative analytics assess clinical, humanistic, actuarial, and health economic outcomes by applying measurement, probability, and economic theory to evaluate and to simulate outcomes of health policy, clinical practice changes, and economic incentives.
Value Proposition
Complex questions require well-specified approaches with measurable goals to achieve success. Relationships between cause and effect demand a strong conceptual foundation to determine the extent to which the relationships are reliable.
Clinical encounter, medical claims, and other large healthcare data sources must be secure while providing the appropriate access to define relationships between data elements, to identify missing and updated medical billing records, and to query the databases to support analytic reporting and decision making. The Livanta team integrates data from multiple sources through structured processes of extraction, processing and loading for warehoused data or for securely accessed remote data.
Value Proposition
Data is an asset when it provides the ability to perform analytic reporting and support decision making. Data can also be a liability when it is not secure.
Livanta’s analytics services transform clinical and economic data into powerful visual information that can be compared against benchmarks or trends to make actionable decisions.
Value Proposition
Expertise in visual analytic approaches establishes a reporting environment that gives the end client the ability to ascertain health outcomes information and clinician practice patterns in the data without diverting end use attention to the statistics behind the analysis.
Special Studies
Livanta develops strategies for special studies and conducts complex medical reviews of selected sampled claims and medical records. The result is a high standard of effective and accurate evaluation of healthcare claim reporting.
Value Proposition
Focused Review processes support confirmation and correction of healthcare quality of outcomes.
Under Medicare leadership, Livanta proposes and completes special measures based on confirmed quality concerns. Using sound data analytics, Livanta promotes understanding and correction of these concerns.
Value Proposition
Livanta contributes to improved healthcare outcomes and cost reductions by identifying errors and promoting solutions.
Livanta’s Topic Trends services provides broad metrics of population health data (such as social determinants of health in COVID-19) helping to identify emerging or increasing strain on the population and elucidating new patterns to positively impact population health.
Value Proposition
Connecting healthcare population trends with root data evaluation promotes awareness, analysis and correction of a given healthcare concern.
