Pay-for-Performance

Industry sources identify “Big Data” as being the key for health systems to cope with the pay-for-performance (P4P) aspects of existing payer contracts as well as successfully pivoting to the paradigm of population health management, expected to be the future of healthcare practice and finance.

  • We have established a priority to assist clients in dealing with the most obvious opportunities to improve quality and reimbursement, namely the several pay-for-performance programs sponsored by CMS and selected commercial payers.
  • Our initial CMS targets are HCC, Annual Wellness, Chronic Care Management, and CJR program status and reporting. For these programs, we have developed reusable analytics objects which will support rapid assessment of program status and development steps to improve outcomes.
  • Our approach marries a powerful analytics tool and a keen understanding of the data requirements behind these P4P plans and to:
    • Avoid long-term technology purchase decisions
    • Adapt easily to a fund-as-you-go model

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