Beaumont ACO: Using Specialist Cost Scoring to Improve Referrals

Challenges

Beaumont ACO sought to leverage a rating system that would accurately capture a provider’s cost effectiveness, as determined by specialists and PCPs themselves, while demonstrating the drivers of the rating system and providing actionable insights that could be used to improve performance.

How we helped

We provided the Provider Performance Index (PPI) to the ACO and worked with the team to evaluate the methodology and ensure that it met the requirements that the ACO was seeking.

The ACO determined that our PPI accurately and consistently captured the nuances (e.g. risk panel, patient population, sub-specialization) associated with cost effectiveness by working with physician leaders in high-impact specialties, namely: Cardiology, Pulmonology, and Gastroenterology. We worked with the ACO to integrate our cost scores into the PCP performance education process and to the physician portal (and phone app) that providers can access anytime.

Impact

The inclusion of these scores has enhanced provider education and allowed providers to have a clearer picture of the cost effectiveness of the specialists that they are referring their patients towards. These insights into the performance of specialists have proved invaluable to the assessment of provider performance and specialist distribution payments in a network of over 5,000 physicians.