Beaumont ACO Uses Specialist Cost Scoring to Improve Referrals
Beaumont ACO has over 325K covered lives, including 26K Medicare Shared Savings Program beneficiaries.
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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 CareJourney Helped
CareJourney provided its 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 CareJourney’s 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. CareJourney and the ACO worked together to integrate CareJourney’s 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.
325,000+
Covered Lives
“CareJourney’s Provider Performance Index has been very helpful in providing an accurate and consistent rating system for specialist referrals. It is used in many areas of our ACO.
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Steve Maney |