{"product_id":"healthcare-sql-comprehensive-guide-100-real-world-analytics-scenarios-for-payers-providers-population-health-9781971447193","title":"Healthcare SQL Comprehensive Guide: 100+ Real-World Analytics Scenarios for Payers, Providers \u0026 Population Health","description":"\u003cp\u003e • Author(s): Urmi K. Doshi\u003cbr\u003e • Publisher: Omkrust Press\u003cbr\u003e • Publisher Imprint: Omkrust Press\u003cbr\u003e • BISAC: Languages - SQL\u003c\/p\u003e\u003cp\u003eKnowing how to write a SQL statement is \u003cb\u003eno longer enough\u003c\/b\u003e to succeed in health informatics. AI can generate the syntax - but it cannot tell you whether the answer is correct. That requires \u003cb\u003edomain expertise\u003c\/b\u003e - and this book builds it.\u003cbr\u003e\u003cb\u003eHealthcare Analytics: Comprehensive Guide\u003c\/b\u003e is the definitive desk reference for data professionals working in managed care, health plans, and population health programs. With \u003cb\u003e31 chapters\u003c\/b\u003e and \u003cb\u003eover 100 real-world analytics scenarios\u003c\/b\u003e, it bridges the critical gap between programming syntax and the deep domain knowledge required to produce results that actually hold up in front of a CFO, a quality director, or a CMS auditor. \u003c\/p\u003e\u003cp\u003e\u003c\/p\u003eStructured around the \u003cb\u003eSTAR methodology\u003c\/b\u003e \u003cb\u003e(Situation, Task, Action, Result)\u003c\/b\u003e, every scenario teaches not just how to write the query - but \u003cb\u003ewhy the data looks the way it does\u003c\/b\u003e, what the business rule actually requires, and what the number means to the organization.\u003cbr\u003e\u003cb\u003eWhat you will master: \u003c\/b\u003e\u003cul\u003e\n\u003cli\u003e\n\u003cb\u003eClaims and Enrollment Fundamentals\u003c\/b\u003e - Inpatient vs. outpatient billing, claim adjudication gates, member months, coordination of benefits, continuous enrollment logic, voids and reversals.\u003c\/li\u003e\n\u003cli\u003e\n\u003cb\u003eQuality and Population Health\u003c\/b\u003e - HEDIS measure construction from denominator to rate, CMS Star Ratings end-to-end pipeline, 30-day readmission prevention, and risk stratification models that identify rising-risk populations before costs escalate.\u003c\/li\u003e\n\u003cli\u003e\n\u003cb\u003eRisk Adjustment and Regulatory Compliance\u003c\/b\u003e - CMS-HCC RAF score calculation, RAPS\/EDPS encounter submission, retroactive payment cycles, and RADV audit preparation.\u003c\/li\u003e\n\u003cli\u003e\n\u003cb\u003eFinancial and Network Analytics\u003c\/b\u003e - PMPM medical cost trend decomposition, MLR calculation, Value-Based Care shared savings, fee schedule analysis, and out-of-network leakage detection.\u003c\/li\u003e\n\u003cli\u003e\n\u003cb\u003eAdvanced Domain Analytics\u003c\/b\u003e - Pharmacy adherence (PDC), PBM spread pricing detection, oncology cost decomposition, maternal care episodes, and behavioral health parity analytics.\u003c\/li\u003e\n\u003cli\u003e\n\u003cb\u003eData Architecture and Advanced SQL\u003c\/b\u003e - Star schema design, SCD Type 2 joins, claims lag management, window functions, recursive hierarchies, and query optimization for enterprise-scale datasets.\u003c\/li\u003e\n\u003c\/ul\u003eEvery chapter closes with \u003cb\u003ekey takeaways\u003c\/b\u003e and a \u003cb\u003eunit test\u003c\/b\u003e - multiple choice and short answer - so you can immediately verify your mastery of both the business rules and the SQL logic required to execute them.\u003cbr\u003eThis guide gives you the \u003cb\u003eframework, the logic, and the confidence\u003c\/b\u003e to turn raw claims data into \u003cb\u003edefensible, actionable answers\u003c\/b\u003e","brand":"Omkrust Press","offers":[{"title":"Paperback","offer_id":47883306696855,"sku":"9781971447193","price":2961.0,"currency_code":"INR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0666\/3471\/1191\/files\/9781971447193.webp?v=1781101011","url":"https:\/\/atlanticbooks.com\/products\/healthcare-sql-comprehensive-guide-100-real-world-analytics-scenarios-for-payers-providers-population-health-9781971447193","provider":"Atlantic Books","version":"1.0","type":"link"}