A Population Based Approach to Pay for Value: RowdMap, Inc. Contributes to Health Care Transformation Task Force White Paper

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RowdMap Inc. is a proud participant on the Health Care Transformation Task Force, contributing to newly released white paper: “Pro-actively Identifying the High-Cost Patient Population: Insights from the Health Care Transformation Task Force.”

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Accurately identifying high cost populations is important in a value-based context in order to better allocate resources, to create more comprehensive risk arrangements and to more accurately measure the success of both.”

RowdMap Inc. is a proud participant on the Health Care Transformation Task Force, contributing to newly released white paper: “Pro-actively Identifying the High-Cost Patient Population: Insights from the Health Care Transformation Task Force.” The paper was published July 1st and is available at: http://www.hcttf.org/resouces-tools.

The Healthcare Transformation Task Force 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 CMS and public and private stakeholders to turn away from fee for service arrangements and to accept risk arrangements.

The importance of this group’s efforts is enormous due the CMS mission to shift 50% of spending to pay for value programs by 2018. As the transformation from fee for service to pay for value accelerates, health plans and providers are struggling to understand what strategies to apply to create and maintain market value while achieving triple aim goals. Many providers and plans struggle to understand newly released government data in order to apply it to a pay for value business model. Some providers and plans struggle to identify and manage the 30% of spending that goes to no-value care, or, care that fails to yield measureable outcomes over a total basket or across an episode. No-value care is epidemic across all populations including high risk and high cost populations and while it drives billing in fee for service arrangements success in pay for value models comes from identifying and managing unnecessary spend. The mission of the Health Care Transformation Task Force is to assist the healthcare industry in working together to provide knowledge and understanding about this switch from fee for service to pay for value.

One of the task force’s priorities is to improve care for high cost patients and identifying the gaps in care. RowdMap Inc. participates on the High Cost Patient Work Group and contributed to the newly-released white paper entitled “Pro-actively Identifying the High-Cost Patient Population: Insights from the Health Care Transformation Task Force.” The paper surveys and summaries best practices for identifying 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 the role of publicly available government data sets and population-based approaches to identifying high cost populations and accurately calculating their expected costs. More accurately risk adjusting populations using socio-demographic factors and methods that account for observational intensity bias is important in a value based context in order to better allocate resources through medical management, wellness and population health programs, to create more comprehensive risk arrangements and to more accurately measure their success.

About RowdMap, Inc. :
RowdMap Inc. helps health plans, government payers, providers, and hospital systems develop Risk-Readiness strategies to excel as they transition from fee-for- service to pay-for value. As CMS sunsets fee-for-service payments, RowdMap Inc.'s Risk-Readiness Platform helps payers and providers identify and manage unwarranted and unexpected variation. RowdMap Inc. identifies ideal provider arrangements based on provider practice patterns and population characteristics within a geography. Payers and providers then use RowdMap Inc. to build strategies around these new risk relationships. RowdMap Inc. helps them enter new markets, segment populations, identify waste, design products, and understand referral patterns. RowdMap Inc.'s platform comes preloaded with government benchmarks out of the box no IT integration required. RowdMap' Inc.'s Risk-Readiness Platform works across all market segments and has significantly larger returns than traditional, medical economic approaches.

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Joshua Rosenthal
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