High-performing networks are not enough to succeed in value based arrangements; classic triple aim measures miss a major key to success in risk: reducing low-value care.
Washington, DC (PRWEB) May 06, 2016
RowdMap, Inc. co-founder, Joshua Rosenthal, PhD, joins Jonathan Blum, Executive Vice President at CareFirst Blue Cross BlueShield and Former Principal Deputy Administrator at Centers for Medicare and Medicaid Services (CMS); Ali Khan, MD, Medical Officer at CareMore - an Anthem Company; Steve Ondra, MD, Chief Medical Officer at Health Care Service Corporation (Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Texas, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma), and Senior Policy Advisor for Health Affairs at the Department of Veterans Affairs in Washington, DC. http://bit.ly/1pJLq13
The session is entitled “Creating a Virtuous Cycle: Designing Networks to Mitigate No-Value Care from Fee for Service and to Create Value-Based Wins for Both Payers and Providers Using CMS Benchmark Data.” The goal of the session is to demonstrate the value proposition for payers and providers to use newly-released government benchmark data to design and curate a Pay-for-Value Ready Network. The session will focus on the need for moving from Fee for Service (FFS) to Value-Based Payment and highlight case studies and real world examples of a variety of health plans and providers using open health data in conjunction with internal information to design provider networks that are succeeding in risk arrangements.
High-performing networks are not enough to succeed in value based arrangements and classic triple aim measures miss a major key to success: reducing low-value care. Thirty cents of every dollar paid goes to low-value care, or procedures and prescriptions that do not produce any additional positive outcomes. Low-value care accounts for roughly 3% of GDP and drove billing in Fee-for-Service economic arrangements. The key to succeeding in value based programs and risk arrangements is identifying and reducing low value care. Newly released CMS data allows anyone to determine design and curate a network of providers to succeed in value based programs. Join this session to see real-world, operational examples of a virtuous cycles where payers and providers successfully reduce low value services and share the positive results.
The session will take place at Health Datapalooza, a national conference hosted by AcademyHealth and the Department of Health and Human Services. Health Datapalooza is focused on liberating health data, and bringing together the companies, startups, academics, government agencies, and individuals with the newest and most innovative and effective uses of health data to improve patient outcomes. Keynote speakers include Vice President of the United State Joe Biden; Sylvia Mathews Burwell, Secretary of Health and Human Services, US Department of Health and Human Services; Patrick Conway, MD, Deputy Administrator for Innovation and Quality and CMO, Director, Center for Clinical Standards and Quality (CCSQ) and Center for Medicare and Medicaid Innovation (CMMI), CMS; and Andy Slavitt, Acting Administrator, CMS.
The session is part of the Payer and Risk-Owner track, a series of sessions designed to health plans and providers taking on risk and participating in value-based care. It will be held on Monday, May 9th, 2016 at The Grand Hyatt, Washington, DC. http://healthdatapalooza.org/
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