Analytics Solution Pilot Program Launches to Validate Cost of Care Improvements
ArborMetrix, Inc., a leading provider of real-time healthcare analytics, has announced that Atrius Health, a non-profit alliance of six community-based medical groups and a home health care and hospice agency dedicated to transforming health care across eastern and central Massachusetts, will be using the ArborMetrix value-based purchasing solution in a pilot program.
ArborMetrix’s software will be used by Atrius Health to analyze cost and variations in practice patterns for several surgical specialties. It will provide information Atrius Health needs to pinpoint drivers of clinical and medical expense variation which will support physicians in providing better quality and more affordable care consistently.
Information on these drivers will be provided based on surgical specialty, both by hospital and by surgeon; physician and hospital outliers; and preferred provider networks for orthopedic and cardiology services.
Newton, Mass.-based Atrius Health treats about half of the 1 million patients it serves on an at-risk basis through various value-based contracts. These contracts include accountable care organization (ACO) agreements that reward better quality metrics and outcomes achieved, rather than paying only per visit, service and procedure, as is the case under the current fee-for-volume system.
Atrius Health is one of 32 Medicare Pioneer ACOs, which were selected by the Centers for Medicare and Medicaid Services (CMS) as leaders in coordinating care for patients across care settings.
“As a Medicare Pioneer ACO, it is tremendously challenging and time-consuming to identify and cost each of the components of an episode of care,” said Joe Kimura, MD, MPH, medical director for analytics and reporting systems at Atrius Health. “After evaluating several episode grouper products, we were most encouraged with the technical and analytic capabilities within the ArborMetrix solution. We are excited to test the product’s ability to help Atrius Health identify actionable drivers of unnecessary variations in cardiology and orthopedic episodes.”
Atrius Health, which includes 37 internal medicine practices that are certified as Level 3 (the highest level possible) Patient-Centered Medical Homes by the National Committee for Quality Assurance, will deploy ArborMetrix’s software in the pilot program to analyze clinical and cost variations for six orthopedic and cardiology episodes of care:
- Hip fracture
- Hip replacement
- Knee replacement
- Heart failure
- Heart attack
- Percutaneous coronary intervention
“I appreciate the commitment of John D. Birkmeyer, MD, the founder of ArborMetrix, to developing grouper methods designed to be accurately applied at the physician level,” Kimura said. “We have high hopes for this technology. Assuming positive pilot results, we are committed to broadly adopting ArborMetrix as an integrated part of our analytics suite.”
Medicare Pioneer ACOs participate in shared savings and losses with Medicare after meeting quality performance levels. The more that Pioneer ACOs are able to both improve outcomes and minimize and prevent avoidable or unnecessary expenses, the more they may be eligible to earn. On the flip side, they will incur greater losses if they cannot both improve outcomes and decrease expense trends.
“We applaud Atrius Health for its forward-thinking and leadership in improving quality and cost-effectiveness of care as their network accelerates toward a value-based purchasing model,” said Brett Furst, ArborMetrix’s CEO. “Too many initiatives have been missing the immediate opportunity to move the needle on clinical performance through episodic analysis of acute and specialty care. With this pilot program, Atrius Health is leading the way in navigating the turbulent waters of taking on risk.”