Using the public benchmark data allows providers to pick the right value based program. This may mean a traditional ACO, a next-generation ACO or a Virtual ACO with a Payer partner. In other words, one size doesn't fit all.
Louisville, KY (PRWEB) September 29, 2015
Joshua Rosenthal, PhD, Chief Scientific Officer and Co-Founder at RowdMap, Inc., will be speaking on how doctors can use newly released government data providers to determine whether they will experience Pay for Value and triple aim success in a traditional Accountable Care Organization, a next-gen ACO, an alternative government program such as bundled payments or a “Virtual ACO” with a Payer partner at the 2015 Florida Association of Accountable Care Organizations (FLAACOS) National Conference, Tuesday, October 1st, 2015 – Orlando, FL.
Florida is the state with the most Managed Shared Savings Programs (MSSPs) and Accountable Care Originations (ACOs). FLAACOs is the premier professional organization for Accountable Care Organizations throughout Florida. Success in an ACO or alternative value based model comes from improving the efficiency, quality and experience of care. Last year the US spent $850BB on low and no value care from higher intensity, and riskier treatment options that deliver no additional benefits to patients. Thirty cents of every dollar and up to 42% of patients receive his care every year. This low and no value care is driven by a Fee for Service (FFS) economic model where doctors and hospitals are paid more for doing more, and higher intensity treatment. This unnecessary spending far outweighs fraud, waste and abuse, but is not identifiable from traditional utilization reviews and unit cost analysis.
The Centers for Medicaid and Medicare Services (CMS) and CMMI have created a number of innovation programs to move from FFS to shared risk and value-based care, delivery and payments including ACOs and have recently announced a Next Generation ACO Model. http://innovation.cms.gov/initiatives/Next-Generation-ACO-Model/
CMS has made historic data releases including the largest data set of doctors and hospitals in history to support identifying provider practice patterns with national and regional benchmarks in order to transition the delivery of care to value based payments. https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2015-Press-releases-items/2015-06-01.html
RowdMap, Inc. Chief Scientific Officer, Joshua Rosenthal, PhD, will deliver a presentation on how providers can use these public data sets to determine whether they will experience Pay for Value and triple aim success in a traditional Accountable Care Organization, a next-gen ACO, an alternative government program such as bundled payments or a “Virtual ACO” with a Payer partner. The government data also allows providers to benchmark payers and determine which payers will make the best partners for pay for value arrangements and then negotiate with them from shared government benchmarks. http://www.cvent.com/events/flaacos-fall-2015-conference/custom-114-06ec789d10af4164b1e47de1ecc297d0.aspx?cpc=V5NKPDZG6QR
“Often doctors are creating hidden value as those most effectively managing no and low value care create the most value for whoever owns the risk, fail to get credit for it in unit cost or utilization reviews, even when case mix adjusted. Using the public benchmark data allows providers to pick the right value based program to get credit for their work. This may mean a traditional ACO, a next-generation ACO or a Virtual ACO with a Payer partner. In other words, one program does not work in every circumstance. A provider practicing the same way may experience wild success in one program but a marked lack of success in another because of how the particular program accounts for, or fail to account for, the population characteristics and the supply of care. Fortunately, the new data allows providers to visibility into intelligently making this decision.” Joshua Rosenthal, Chief Scientific Office, RowdMap, Inc.
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.