Pressure is On: Improve Quality of Healthcare, Reduce Costs

Boise, ID, March 4, 2015 (Newswire.com) - In partnership with The Department of Health and Human Services (HHS), The Centers for Medicare and Medicaid Services (CMS) have been working on testing and expanding new health care payment models that will improve the overall quality of healthcare all while reducing costs.

In January, Bloomberg Business published an article on the overhaul of Medicare payments to doctors and hospitals. As reported by the article, the Obama administration is expected to make historic changes under the Affordable Care Act (ACA) that would increase the transparency of the costs of insurance plans in order to promote lower-cost options. “Starting next year, Medicare will base 30% of payments on how well health providers care for their patients, with a goal of shifting half of payments under the new system by 2018.”

Healthcare regulations are pushing for improved quality of care, while simultaneously calling for a reduction in healthcare costs. When analytics are called to the rescue, say hello to Proskriptive.

According to a press release published by CMS on January 26 of this year, the suggested shift would reward value and care coordination, rather than volume and care duplication. “To help drive the health care system towards greater value-based purchasing –

Rather than continuing to pay the same amount to everyone regardless of the quality of care delivered – HHS seeks to have 85 percent of Medicare fee-for-service payments in value-based purchasing categories 2 through 4 by 2016 and 90 percent by 2018.” This means that by the end of the government’s fiscal 2016 year, they expect to have 85% of Medicare payments tied to quality or flown through a population health contract.

Currently, we are nowhere near that total, meaning there will be a significant need for virtually every hospital or health care provider who accepts Medicare in the United States to develop the ability to better manage population risk and quality of care. However, there are a limited number of companies in the industry equipped to complete this task at a cost that is reasonable for small to midsized providers. Although advanced data analytics is able to provide key information, most offerings do not have the ability to keep up with the changes occurring in healthcare infrastructure.

Fortunately, Proskriptive offers a scalable solution, called the Wellness Automation Platform that is designed to help meet this need at a price that is suitable to small and midsize provider groups. Proskriptive is already working with a number of providers to deliver a consolidated data infrastructure to enable patient engagement as well as tracking quality of care and identifying improvement opportunities. In addition, the Proskriptive Wellness Data Repository is designed to support provider’s needs as they grow by offering a centralized data repository for core applications that are in place today and architected to be flexible for future needs.

This announcement by CMS should serve as a reminder that the rapid pace of change in healthcare will continue through the end of the decade and beyond. The need for high quality analytics that will simplify initiatives to promote better quality and lower costs is upon us and Proskriptive is here to support healthcare providers paving the road for the future. Contact Proskriptive to learn more about how Wellness Automation can work for you. Call 208-629-7992 or email [email protected]

About Proskriptive

Based in Boise, Idaho Proskriptive utilizes advanced analytics, offers expert services, and develops impactful solutions that identify hidden opportunities within an entire population, to enable better population care and more efficient management of healthcare resources.