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Provider profiles exist in two states:

  • What Providers Do: we analyze administrative claims information to provide current representations of how each HCP and HCO (HCO Group Practice and HCO Facility) provider performs using objective performance measures.
  • Who Providers Are: we analyze online and offline sources of information to provide current representations of each HCP and HCO (HCO Group Practice and HCO Facility) provider’s demographic information.

Let’s focus on the harder part first.  In order to understand “What Providers Do”, PurpleLab has developed our Agile Provider Profiling Platform™.  This platform provides on-demand access to an integrated warehouse of patient-level, medical claims for purposes of profiling the census of the nation’s individual (HCP) and organizational (HCO Group Practices and HCO Facilities) healthcare providers.

Profiling based on performance information involves analyzing claims histories for purposes of developing peer-to-peer comparisons of each healthcare provider’s performance relative to every other healthcare provider based on objective measures. By analyzing performance information over time, PurpleLab can help you understand how individual (HCP) and organizational (HCO Group Practices and HCO Facilities) healthcare providers performances are trending and even forecast future performance.

PurpleLab™ has “curated” 4 query and report templates for purposes of answering the most often asked provider profiling questions.  These templates offer virtually limitless customization based on submission of user-specified parameters.  Our Agile Provider Profiling Platform is an environment where non-programmer, business analyst users can access and develop complicated queries using a visual programming, “wizard-driven” interface.

In a few simple clicks, users submit their customized parameters to any of the 4 query and report templates to benchmark the nation’s healthcare providers:

Experience Report Retriever: Benchmark each HCP, HCO Group Practice and or HCO Facility and provide peer-to-peer rankings based on longitudinal analyses of each provider’s volumes of diagnoses and/or procedure claims. Experience Report Retrievers provide event (claim or patient) counts by year, counts by setting, totals across years, trends, forecasts and projections.
Outcomes Report Retriever: Benchmark each HCP, HCO Group Practice and or HCO Facility and provide peer-to-peer rankings based on a longitudinal analysis of each provider’s volumes of “adverse” events. Use any standard measure, such as Mortality, Hospital Acquired Conditions (HACs), Central Line-associated Blood Stream Infection (CLABSI), Catheter-Associated Urinary Tract Infection [CAUTI), Surgical Site Infections (SSI), Risk-Standardized Complication Rates (RSCRs), Prolonged Length of Stay (prLOS) or Risk-Standardized Readmission Rates (RSRRs), Excess Acute Care Days (EDACs) and apply one of the standard measures to any of the more than 1,500 pre-built conditions or procedure code groups. View standardized reports for each providers crude measures, risk adjusted measures and see their expected outcomes, realized outcomes and variations as well as trends, forecast and projections.
Appropriateness Report Retriever: Benchmark each HCP, HCO Group Practice and or HCO Facility and provide peer-to-peer rankings based on a longitudinal analysis of each provider’s volumes of “inappropriate” events. Use any standard measure, such as National Coverage Determinations (NCD), Regional Coverage Determinations (RCD) or paid out False Claims Act cases (FCA) as well as other measures of waste, such as days in ICU prior to mortality. View standardized reports for each providers crude measures, risk adjusted measures and see their expected measures, realized measures and variations as well as trends, forecast and projections.
Cost Report Retriever: Benchmark each HCP, HCO Group Practice and or HCO Facility and provide peer-to-peer rankings based on a longitudinal analysis of each provider’s charges and reimbursements related to events (claim or patient). Combinations of cost comparisons with Outcomes and/or Appropriateness measures ultimately enable peer-to-peer rankings of highest to lowest value ratios.
Enhanced Profile Report Retriever: Our provider masterfile information ranges from extensive demographic profiles to crosswalks of identifiers for both HCP and HCO providers. PurpleLab has also developed and maintains affiliations, or links between HCP and HCO providers. These affiliations include:
HCP to HCO Affiliations: which HCPs practice at which HCOs (including inpatient hospitals, outpatient facilities/clinics, group practices, post acute care facilities and organizations which breaks down to include skilled nursing facilities, home health agencies, hospices, etc.)

HCP to HCP Affiliations: relationships between referring HCPs and rendering HCPs

HCO to HCO Affiliations: relationships between HCO Groups and HCO Facilities and Health Systems and/or Integrated Delivery Networks.

PurpleLab’s strategy is to be the most efficient manufacturer and cost-efficient offerer of provider profile data in the industry.

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