NEW Data Analytics + Support Resources = RESULTS
1. Data Analytics
In launching our group, we worked in tandem with developers and providers to build our own proprietary data analytics engine. This engine takes raw claims data directly from participating payors on ALL claims data, not just diagnosis found within practice EMR. We then take that data and identify the highest risk patients and target resources towards them.
In addition, our analytics identify gaps in care, which gives our providers the actionable information they need to better serve their patients.
All this information is available at no out of pocket cost to our providers in a simple, easy-to-use dashboard.
2. Care Management Support
In addition to the data analytics, we have also built a team of nurses as health coaches who are available at no out of pocket cost to supplement our clinic providers in managing their patients. This allows our providers to “hand-off” (at their discretion) their high-risk patients to a team that will help these patients accomplish their health goals and better follow their PCP’s directives. We have found this to be effective as we further our efforts towards preventative medicine, reducing avoidable hospitalizations and avoidable hospital readmissions.
Process Improvement Specialists
• Medication Adherence
•Weight Management and Dieticians
•PCP Follow Up
3. Risk Stratification
80/20 RULE – 80% of the total costs come from the sickest 20% of the population
60/5 RULE – 60% of the total costs come from the sickest 5% of the population
Our data analytics identifies the most at-risk patients and what their gaps in care are. By combining that information with our targeted care management support, we can show providers how they can grow their bottom-line by over $200k per provider.
In kicking off Performance Year 2 (2014), one of our goals is to partner with local hospitals on information exchange so that all providers have the most updated information. In order to continue driving down claims cost, it is imperative that there is collaboration between our practices and hospitals regarding admitted or discharged patients. We must insure the exchange of accurate and timely information to treat and follow up with our patients as they transition from hospital care back to their primary care provider/medical home.
In addition, we are now the only organization in the state to have a track record of proven results in saving claims dollars. We can use this as a basis for the creation of new opportunities with multiple payors that are both FAIR and SUSTAINABLE for ALL parties, as well as present a business solution for streamlining quality metrics and expectations!
As we move forward, we will continue to test and implement a variety of cost-saving strategies, narrowing our scope as we go to pinpoint programs that bring our organizations the most return on their time and energy.
Exciting Collaboration Opportunity
The opportunities to increase patient health, improve healthcare outcomes, and decrease overall cost are almost limitless, and we invite and encourage all our providers to collaborate with us on their ideas. By identifying practical, innovative, common-sense strategies and sharing best practices across a statewide network of providers, we can make a huge difference. A high tide raises all ships!
The programs we are creating are a powerful alternative to the rapid consolidation in the healthcare industry. Our growing group of aligned healthcare providers holds enormous appeal for providers who are interested in identifying and employing “best practices” into their clinics and generating diversified revenue streams.
We are excited about sharing our story and vision with you! Please Contact US so that we can tell you more about our successes, and hear about your ideas for achieving better health outcomes!