Transcarent Leverages CareJourney to Empower Consumer Choice & Establish Centers of Excellence (COE)

Challenges

Transcarent wanted a data partner to deliver information on healthcare quality and value to help consumers to make better decisions about their care. They needed clinically-relevant, specialty-specific, and statistically rigorous cost and quality insights data that could be easily integrated into the Transcarent platform, workflows, and consumer apps.

Specifically, the Transcarent team wanted to:

• Tier their provider network by performance across multiple dimensions based on statistical analysis of millions of patient journeys
• Identify Centers of Excellence (COE) facilities to route patients to the appropriate facility for elective services

How CareJourney Helped

After a rigorous evaluation of their options, Transcarent chose CareJourney for the granular insights it offers on providers, facilities, and practice groups. CareJourney stood out with its ability to quantify volume and experience, high-value care, quality care, and cost efficiency in provider and specialist performance assessments. Transcarent integrated CareJourney’s Provider Intelligence data directly into their Provider Finder and Case Placement Tool to arm patients with easy-to-understand decision aids as they look to select the right provider. Additionally, Transcarent uses CareJourney data to assist care coordinators in selecting the appropriate COE for those seeking care.

The CareJourney data platform arms Transcarent with detailed physician classifications, episode cost benchmarks, and quality measures, in addition to scoring for physicians, practices, and facilities in commercial markets across the country. The data covers key specialties such as Orthopedics, Cardiology, Obstetrics and Gynecology, Primary Care, and Pediatrics. Transcarent integrates CareJourney data via Snowflake, with data available immediately, reducing ingestion and ETL burdens.

Impact

With comprehensive and accurate data from CareJourney, Transcarent is able to offer flexible pricing options to their customers that are tied to measurable results – either low at-risk per employee pricing or shared savings pricing. It also allows them to confidently cut out unnecessary administrative costs through direct contracts with quality providers, and connect patients to appropriate sites of care.

Additionally, in partnering with CareJourney, Transcarent was able to consolidate several data partnerships down to one, thereby accruing savings and efficiency in providing their members with daily access to high-caliber physician performance assessments to make smarter healthcare decisions.