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2017 ACO Results: A Summary of What Mattered Most

September 11th, 2018

Last week, CMS published the 2017 performance year results for the Medicare Shared Savings Program (MSSP). It comes on the heels of a new proposed rule from CMS […] Read more

The new MSSP rule: the questions we should be asking

August 31st, 2018

As most of you are already aware, CMS released a rule proposing changes to the Medicare Shared Savings Program earlier this month.  By now, you have probably read several summaries […] Read more

The CareJourney Difference

The CareJourney Approach

Actionable Worklists Actionable Insights
No Black Boxes No Black Boxes
Return of Investment ROI Focused
Member Driven Member Driven
60 Days to Success

The CareJourney Platform Delivers Clinically-Relevant Analytics

Clinical vs Insurance Analytics

Open Care Models

Open Care Models
  • Annual Wellness
  • Shared Decisions
  • Transitional Care
  • Diabetes Prevention
  • Chronic Care Mgmt

Open Risk and Segmentation Models

Code to Care Model
  • Rising-Risk (Frailty)
  • Hotspotters
  • Chronic Condition
  • Medicare Cohort
  • HCC Risk Score

How CareJourney Helps Members Achieve Savings

Reduce Unnecessary Care

Savings Opportunity
“Don’t do that” and/or “do that differently”

  • Duplicative or unnecessary procedures
  • Clinically-equivalent substitutions
  • Patient routing errors
  • Spend outliers across episodes of care

Illustrative Example
Use of lower-cost, clinically equivalent drugs can yield thousands in potential savings per treatment

2017 Utilization 2017 Spend
2017 Utilization 2017 Spend

Bolster High ROI Interventions

Savings Opportunity
“We should have done this”

  • Smarter patient risk segmentation
  • Evidence-based care models such as Transitions of Care, Chronic Care Management, Annual Wellness
  • Compliance and ROI measurement

Illustrative Example
Care Model compliance for targeted patient segments can drive millions in potential savings

Per Member Cost (K)

Per Member Cost

Interested in Learning More?

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