Health plans and physicians are recognizing the role and impact of identifying, quantifying and reducing no-value and low-value care in achieving success in pay for value programs.
Washington, D.C. (PRWEB) February 28, 2016
RowdMap Inc. is a proud participant on the Health Care Transformation Task Force, contributing to newly released white paper: "Developing Care Management Programs to Serve High-Need, High-Cost Populations." The paper was published February 23rd and is available at: http://www.hcttf.org/resouces-tools.
The Healthcare Transformation Task Force (HCTTF) is a group of private sector stakeholders ranging from providers, health plans, employers, consumers, to academic institutions. Their common goal is to create better care organizations by changing healthcare business models to focus on better health, better care, and lowering costs through value based arrangements.
The task force is comprised of 25 health insurances and 6 top health systems that have collectively committed to put 75% of their business into value based arrangements by 2020. The main goal of this group is to combine policy and technical support from the private sector with the work being done by the Centers for Medicare and Medicaid Services and public and private stakeholders to turn away from fee for service arrangements and to accept risk arrangements.
RowdMap Inc. participates on the High Cost Patient Work Group and contributed to the newly-released white paper entitled "Developing Care Management Programs to Serve High-Need, High-Cost Populations." The paper surveys and summarizes best practices for managing high cost populations with particular applications to the impact of these populations on the transition from fee for service arrangements to value based models.
A particular area of contribution includes identifying, quantifying and reducing no-value and low-value care. This is care that patients may neither want nor need but drives billing in a Fee for Service economic model. No-value care accounts for thirty cents of every dollar spent in healthcare, or roughly 3% of GDP. Successful Pay for Value programs and risk arrangements mitigate this low-value care by eliminating care that does not improve clinical outcomes.
Specifically, the HCTTF recommends that entities structuring care management programs measure and monitor participating providers and the extent to which they are delivering low- or no-value care and also recommends that the Centers for Medicare and Medicaid Services include low- and no-value care as a component of evaluation criteria for success in value-based programs.
“Both health plans and physicians are recognizing the role and impact of identifying, quantifying and reducing no-value and low-value care in achieving success in Pay for Value programs. The Health Care Transformation Task Force and its members are dedicated to succeeding in this transition and are exercising significant leadership in bringing this issue to the forefront as a key to system-wide success across various Pay for Value programs and risk arrangements,” said Joshua Rosenthal, Chief Scientific Officer at RowdMap, Inc. and contributor to the HCTTF paper, “Developing Care Management Programs to Serve High-Need, High-Cost Populations.”
About RowdMap, Inc. :
An Ernst and Young EY Entrepreneur Of The Year® winner, RowdMap’s Risk-Readiness® benchmarks help health plans, physician groups, and hospital systems identify, quantify, and reduce no-value care that physicians deliver—a central tenet of successful pay-for-value programs.
Through practice pattern and referral analysis, RowdMap’s benchmarks identify the health care entities that manage unwarranted and unexpected variation in care. This variation leads to more than $850 billion in no-value care annually. Payers and physicians use RowdMap’s physician and population health benchmarks to create strategies that put these highest performing physicians at the center of networks and then design products, organize clinical programs, and coordinate sales and marketing around them. RowdMap’s platform comes preloaded with benchmarks for every physician, hospital, and zip code in the United States—no IT integration required. RowdMap's Risk-Readiness® Platform works across all market segments and has significantly larger returns than traditional medical economics approaches.
For more information, please visit http://www.RowdMap.com