Providers have an increasingly wide range of pay for value programs from which to pick, whether ACOs or other risk arrangements. We are excited to bring government benchmark data to their strategy and management.
Louisville, KY (PRWEB) August 17, 2015
The National Association of Affordable Care Organizations (NAACOS) is a coalition of Accountable Care Organizations (ACOs) organized to contribute to public policy, education on payment models and best practices, and establish national metrics for benchmarking data. But for providers participating in ACO programs, the landscape is changing. Participants of ACO programs may fail to demonstrate savings or improvement and some have dropped out, and, at the same time, the Centers for Medicare and Medicaid (CMS) have announced new versions of ACOs: http://innovation.cms.gov/initiatives/Next-Generation-ACO-Model/ CMS is also launching additional pay for value arrangements, such as the flat fee payment for orthopedics, which may compete with impact ACOs: http://www.hhs.gov/news/press/2015pres/07/20150709.html
Fortunately, CMS has also made historic releases of provider data to measure the impact of ACO programs. While traditional ACO benchmarks focused on the operational data, the new CMS data allows measuring something far more meaningful, unnecessary spend and no value care. Thirty cents of every dollar goes to unnecessary spend and up to 42% of patients in any given year experience unnecessary treatment. This unwarranted variation has been well documented and its definitions are publically available from the Dartmouth Atlas for Unwarranted Variation: http://www.dartmouthatlas.org/ The CMS releases of the largest provider data sets in history allows identifying national and regional benchmarks for unnecessary spend and no value care for every primary care physician, specialist, hospital and post-acute center including ACO participants: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-06-01.html While unnecessary spending drove billing in Fee for Service payment models, pay for value programs including ACOs succeed by mitigating this and delivering appropriate care.
RowdMap, Inc. helps providers use these data to determine whether participating in an ACO or other risk arrangement not only meets operational metrics, but whether the program participant is mitigating unnecessary spending and no value care to lower costs, improve patient experience and minimize complications and negative outcomes for patients. Pay for value programs may succeed or fail based on the populations they serve and the relationship of the provider’s performance to these populations. RowdMap, Inc. benchmarks populations and their characteristics with this new public CMS data which has been shown to measure a population’s disease burden and associated costs better than claims or electronic health records, both of which suffer from observational intensity bias: http://www.bmj.com/content/348/bmj.g2392 RowdMap, Inc. helps ACOs, determine a population’s impact on the success of an ACO program, but also quantifies the impact of a population on an ACO’s performance. RowdMap, Inc. helps providers identify whether an alternative pay for value program may be a better option such as a Managed Shared Savings Program, a bundled arrangement, or a capitated arrangement or curated network with a payer partner. “Providers have an increasingly wide range of pay for value programs from which to pick, whether ACOs or other risk arrangements. We are excited to bring government benchmark data to their strategy and management.” Ashley Distler, Senior Client Strategist, RowdMap, Inc. For ACOs, RowdMap, Inc. uses the new public benchmark data to help participants make informed decisions about whether to remain in a traditional ACO, join a next-generation ACO, or enter into a Virtual ACO with a payer partner.
RowdMap, Inc. uses government benchmark data to help providers participating in ACOs or alternative arrangements successfully make the transition to shared risk and actively participates with and supports industry coalitions. RowdMap, Inc. is pleased to add NAACOS as a partner and support NAACOS in their efforts and goals of education, policy participation and benchmarking data: https://www.naacos.com/partners/
About RowdMap, Inc. :
An Ernst and Young EY Entrepreneur Of The Year® winner, RowdMap helps health plans, government payers, providers, and hospital systems develop Risk-Readiness (SM) strategies to excel as they transition from fee-for- service to pay-for value. As CMS sunsets fee-for-service payments, RowdMap's Risk-Readiness (SM) Platform helps payers and providers identify and manage unwarranted and unexpected variation. RowdMap identifies ideal provider arrangements based on provider practice patterns and population characteristics within a geography. Payers and providers then use RowdMap to build strategies around these new risk relationships. RowdMap helps them enter new markets, segment populations, identify waste, design products, and understand referral patterns. RowdMap's platform comes preloaded with government benchmarks out of the box no IT integration required. RowdMap's Risk-Readiness (SM) Platform works across all market segments and has significantly larger returns than traditional, medical economic approaches.