Trend Management
Trend Management
Stay ahead of utilization shifts and manage healthcare costs with near real-time trend insights
The Challenge
Payers struggle to detect and respond to emerging utilization and cost patterns when data arrives in disconnected, delayed batches:
- Siloed sources slow visibility into claims, clinical feeds, and lab/ADT events
- Hidden spikes in service volumes or costs erode margins before teams can intervene
- Manual analysis drains resources and can’t scale with growing membership
The Opala Solution
Opala HealthSynq™ ingests every relevant data stream into a single, normalized feed—so you can spot anomalies the moment they emerge:
- Comprehensive ingestion of claims, FHIR, CCDs, labs, ADTs, and other HL7 messages
- Anomaly detection that flags utilization or cost deviations against your own historical and peer benchmarks
- Configurable dashboards delivering near real-time insights to finance, care management, and network teams
- Seamless integration with your BI tools or via API for deeper modeling and predictive analytics
- Rapid deployment: go from contract to production in 4–6 weeks
Key Benefits
- Catch surges 60% faster than legacy batch reporting
- Reduce cost leakage through proactive interventions
- Empower teams to optimize care pathways based on live trend data
How It Works
- Aggregate & Normalize
All claims and clinical feeds flow into Opala’s unified data pipeline - Benchmark & Alert
Our engine compares current activity to your historical baselines and peer cohorts, triggering alerts on outliers - Visualize & Act
Trend dashboards and push-notifications empower your teams to investigate and correct course before costs escalate
Customer Spotlight
“Opala’s Trend Management solution alerted us to an unexpected spike in post-surgical readmissions—allowing us to deploy targeted case management within days and avert millions in avoidable costs.”
– Leading Regional MA Plan