The new public data allows providers to pick the right components of a capitated arrangement, to identify the right health plan partner with which to participate, to negotiate from shared benchmarks, and to have a meaningful, structured conversation.
Louisville, KY (PRWEB) October 03, 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 and how they will succeed in capitation and value-based risk arrangements. The presentation entitled, “Using Newly-Released HHS Benchmark Data to Negotiate and Succeed in Value and Capitation” will be delivered at the CAPG, The Voice of Accountable Physician Groups, National Colloquium on Tuesday, October 6th, 2015 at the Marriott Wardman Park Washington, D.C. http://www.capgcolloquium.com/agenda/day1.html
CAPG is the leading U.S. trade association for and the voice of accountable physician organizations with a mission to assist accountable physician groups to improve the quality and value of healthcare provided to patients. CAPG represents and supports physician groups that assume responsibility for clinically integrated, comprehensive, and coordinated healthcare on behalf of our patients with a strategic vision of continuing to drive the evolution and transformation of healthcare delivery throughout the nation.
Success in capitation or an 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.
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 and how they will experience Pay for Value and triple aim success in capitation with a Payer partner or an alternative value-based risk arrangement. The government data also allows providers to benchmark payers and determine which payers will make the best partners for capitated and risk arrangements and then negotiate with them from shared government benchmarks.
“Often doctors have hidden value as those most effectively managing no and low value care create the most value for whoever owns the risk, but 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 components of a capitated arrangement and identify the right health plan partner with which to participate. The government benchmarks allow payers and providers to negotiate from shared benchmark data and have a meaningful, structured conversation. The beautiful part is that if one party is more confident about their prospects and abilities, they can jointly configure the arrangement to take on additional risk as well as the corresponding upside. The new data allows providers to intelligently make these decisions.” -Joshua Rosenthal, Chief Scientific Office, RowdMap, Inc.
Those interested in learning more are encouraged to contact RowdMap, Inc. directly or visit RowdMap, Inc. at the 2015 CAPG COLLOQUIUM, Achieving Success in Risk-Based Coordinated Care on October 5-7, 2015 at the Marriott Wardman Park Washington, D.C.
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.