About the customer
180
metrics evaluated per provider
Challenges
It is important for organizations participating in value-based care to ensure patients are getting the highest quality of care holistically, not just within an ACO’s contracted network.
For organizations focusing on primary care, they can help support practice groups by providing them with performance-related information on the surrounding specialist market. This helps primary care physicians make informed decisions when referring patients to specialists.
The organization needed access to timely, relevant data on specialists in the market in order to support its robust primary care network at the point of care.
How we helped
The organization partnered with us to access and analyze data across 180 metrics on 1.7 million providers nationally. It was also able to slice and dice the data to pull relevant insights on:
- Provider/Specialist Performance across both cost and quality metrics for their specific Medicare population.
- Break down and identification of top episodes within specialties to pinpoint performance for specific procedures and/or chronic care management.
- Cost and Outcomes Scores for referring physicians to uncover performance improvement opportunities.
Impact
The organization was able to conduct a vigorous data analysis and validation with key internal stakeholders to leverage data in making informed decisions for building a high-performing specialist network. In the future phases of the project, the organization will:
Open up the data for patients through a self-service, public website so they can make more informed decisions about their own care.
Integrate additional data into their EHR tool so it is accessible at the point of care in all physician offices. Having access to an optimized list of specialists, formulated by area of expertise in chronic condition management and episodes of care, will further empower their PCPs with key data points and metrics for better referral decisions.
Engage with select physician leads for feedback on utilization and insights to facilitate performance improvement conversations.
Lessons Learned
- Data integrated directly into the EHR, so it’s accessible at the point of care in physician offices
- PCPs received an optimized specialist list organized by area of expertise in chronic condition management and episodes of care
- Select physician leads engaged for feedback on utilization and insights to support performance improvement conversations
- Self-service public website gives patients access to the data for their own care decisions
The rigorous analysis of provider performance across 1.7 million Providers nationally helped us engage physicians in performance improvement conversations and empower them to make informed decisions at the point of care.
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