As a prominent health plan with a strong reputation, our client’s nationally recognized value partnership and collaborative quality incentives programs – Practitioner Care Medical Home (PCMH) and Provider Group Incentive Program (PGIP) – are leading the way in controlling health care costs and improving health outcomes. In a continuing effort to grow and evolve their programs, X by 2 collaborated with the client and developed advanced medical informatics and reporting capabilities that enabled them to better evaluate the impact of systemic improvements in care processes and more quickly adapt to industry-wide changes that result from health care reform.
Through its promotion of a PCMH model, our client worked to dramatically improve care quality, lower costs, increase satisfaction by providing incentives for physicians to focus on the overall health and wellness of each patient, and empower members to take more control of their own health outcomes and costs. The health insurer’s ability to grow its programs; however, had become hindered by its inability to efficiently collect and analyze data for various initiatives.
To help maintain its edge and continually evolve the incentive programs, our client required advanced data, analytics, and reporting capabilities to enable the identification and evaluation of systemic improvements in care processes. A key element of this was the measurement of initiative effectiveness from the perspective of results, incentive payout, projected savings and impact on the quality of care.