Customers Get Their Entire Covered Population in One Report Across Multiple Payers Including Medicare
Following the successful completion of Comprehensive Primary Care (CPC) Classic – one of the largest payment demonstration projects in the country – The Health Collaborative has launched an innovative new tool for Ohio healthcare providers as they continue efforts to improve primary care in the region. The hb/analytics Claims Data Co-op service streamlines and enhances reporting capabilities for practices participating in the second phase of the project, Comprehensive Primary Care Plus (CPC+).
The CPC+ program is an initiative of the federal Centers for Medicare and Medicaid Innovation, and is designed to test a new way of paying providers: paying to keep people well. The Health Collaborative is supporting 562 primary care practices (more than 2500 doctors and providers) located throughout Ohio and Northern Kentucky as they implement major changes in patient care coordination. A team of practice support professionals at The Health Collaborative will offer group learning, individual coaching, and technical assistance to help practices successfully meet the expectations and goals of the CPC+ program.
– Larry Ratcliff, MD, Providence Medical Group, Dayton, OH
To help them manage and track changes in patient care strategy, The Health Collaborative has designed and launched the hb/analytics Claims Data Co-Op service to make pay-for-value reporting actionable and meaningful. With this new suite of tools, practices are able to see their entire patient population in one report across multiple insurers including Medicare – capturing progress on cost and utilization measures, and allowing deeper insights by drilling down to patient level detail. Practices can see how they are performing against the benchmark set by all participating practices in the region and fulfill reporting federal requirements.
The hb/analytics service also includes coaching to help interpret reports and explore opportunities for improvement. This service is structured as a “data co-op” so that health plans and regional practices share in the cost and thus the ownership of the aggregated data.
“These practices are transforming the way we pay and provide for healthcare in this country, and we felt it was critical to develop a tool that would allow them to turn data into meaningful strategies,” said Jason Buckner, Sr. VP, Informatics at The Health Collaborative. “We knew doing this efficiently would be key, so we’ve made hb/analytics available to practices at less than 1% of projected care management fee revenue.”
hb/analytics Claims Data Co-Op was born from the need to seamlessly report and compare performance from the 75 Greater Cincinnati practices participating in CPC Classic. Practices struggled with bits of performance information across varying reporting formats from multiple payers, while health plans lacked a credible comprehensive view of a practice’s performance.
“As a former solo family physician, I sympathized with the small independent practices in CPC Classic that had to deal with the reports coming at them from 9 different payers with mixed reviews and no resources to make sense or analyze the results. I recognized early on that if this new approach of payment for the coordination of care had any chance of being successful some consolidation and analysis of this data was mandatory,” says Dr. Richard Shonk, Chief Medical Officer, The Health Collaborative.
“Feedback received from the small practices on the usefulness of these aggregated reports is promising. Many have indicated that it gives them the opportunity to compete on a similar level with practices in large systems,” says Dr. Shonk.
“With a comprehensive look at our patient population, hb/analytics enables us to efficiently report out weekly and monthly to our staff on the areas we’re trying to improve, such as ER visits and overall usage rates. It’s a continued process improvement so that we identify issues before they become big problems,” shares Larry Ratcliff, MD of Providence Medical Group, Dayton, Ohio.
For more information on hb/analytics and our full hb/suite of data and technology services, please contact:
Mary Maune, Account Manager, Large Accounts
513.618.3631 | email@example.com
Sean Flynn, Senior Account Manager
513.247.5257 | firstname.lastname@example.org
More on CPC+
CPC+ is a partnership among Medicare, Medicaid, six managed Medicaid, five commercial insurers, and care providers across the region. These payers have agreed to invest in the selected practices by paying monthly care management fees, which the practices use to improve the coordination of patient care. The fee allows the care team to offer services to patients that are not billable under traditional fee-for-service payment models. Examples include more comprehensive chronic disease management, self-care coaching, support after a hospital discharge, expanded and non-traditional access to care, and other services to keep patients as healthy as possible between visits to the doctor.