The new data gives new into which providers and networks will drive success in the new payment models, and that is the most valuable to those who use it first.
Louisville, KY (PRWEB) August 24, 2016
RowdMap, Inc, was featured in a recently published article in Managed Care Magazine for helping payers and providers identify and create high-value care in order to succeed in the transition from Fee for Service to Pay for Value payment models for the delivery of care.
The article is entitled: “As CMS Opens the Data Vault, Entrepreneurs Build a How-to-Use-It Guide. CMS’s data-liberation movement is helping to accelerate the transition to value- and risk-based payment systems. For payers and providers, the trick is knowing what to do with the data” http://bit.ly/CMSHowToGuide .
The article notes that the Centers for Medicare and Medicaid Services (CMS) have released tremendous amounts of data around the delivery of care, including data on population health, patient referrals and physicians and hospital practice patterns. While there has been progress on various fronts in the healthcare delivery system, such as reducing in-patient days and the adoption of generic drugs, there has not been a discernible impact on the overall expenditure. One of the drivers of healthcare expenditure is low-value care, or care that costs more than alternatives, yet fails to provide additional benefits or improved outcomes. The Institute for Medicine estimates that low-value care accounts for one third of overall healthcare expenditure. The article focuses on RowdMap, Inc.’s Risk-Readiness® Benchmarks, which covers ninety seven percent of providers, including individually physicians by name, and shows how much low-value care physicians create and what drives it, whether it stems from procedures, prescriptions, visits or referrals.
“Providers that generate high-value care are creating value for whoever owns the risk and that can be quantified with specific dollar amounts,” said Joshua Rosenthal, PhD, Chief Scientific Office, RowdMap, Inc. “For payers, traditional approaches such as utilization reviews or actuarial unit cost analysis fail to capture low-value care, which accounts for thirty cents of every dollar. Get that right, and there’s more than enough resources to properly incentivize all parties to deliver high-value care.” “For providers, getting a third-party assessment on your readiness to take on risk, who your best partners are, and what programs and arrangements will work best for you, is all about transparency,” said Joshua Rosenthal, PhD, Chief Scientific Office, RowdMap, Inc.
The CMS data releases mean that the data is public and the provider profiles do not require IT exchanges or contain Personal Health Information (PHI), which traditionally take time and create dependencies. “The public nature of the data does create a first mover’s advantage,” said Joshua Rosenthal, PhD, Chief Scientific Office, RowdMap, Inc. “New visibility into which providers and networks will drive success in the new payment models is, by nature, the most valuable to those who use it first. And when you are playing for thirty cents of every dollar, that’s a tremendous advantage. This article demonstrates the increasing market adoption by both payers and providers and, now, things get interesting,” said Joshua Rosenthal, PhD, Chief Scientific Office, RowdMap, Inc.
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