At the beginning of June, we sponsored the Fifth National Bundled Payment Summit and it was there that we proudly announced our first ever HCI3 ECR Analytics Certified Partner: HealthQx.
HealthQx (HQX), located in King of Prussia, PA, was founded in 2012 by Mark McAdoo and Bill Conlan to help health plans and health systems by developing solutions that could harvest the intelligence out of big data sources through advanced analytics to support the transition to value based payments. This idea became the genesis for HQX’s value based analytics platform, ClarityQx.
Today, ClarityQx is a Software as a Service (SaaS), value based payment analytics platform. ClarityQx is designed to apply proven techniques in advanced analytics across the various disconnected data sources in the care continuum. Through these capabilities health plans and health systems can accurately define clinical episodes of care, measure variations in care, identify potentially avoidable complications (PACs) and track performance on a risk-adjusted basis. These capabilities are critical to the successful implementation of value based care (VBC) initiatives.
The past few years have been busy for those in the health care industry. Looking back, what does HealthQx consider one of its proudest accomplishments?
At HQX we are proud to be tackling one of the biggest operational issues facing the health care industry – connecting value based care with value based payments. In the initial years of the organization, our team focused on developing ClarityQx to have the capabilities to go far beyond basic analytic reporting. Our objective was to create an analytics software platform that enables health plans and health systems to understand the episode of care opportunities within their populations and collaborate on the best value-based payment model to support the initiative.
As we continue to innovate with ClarityQx we are excited to be the first to complete the new HCI3 ECR Analytics Claims and Provider Analysis Certification. We believe that the adoption of standard-based methodologies is a step in the right direction to achieving a value based payment system that can be adopted nationally.
What is in store for HealthQx moving forward? What opportunities are you most excited about for the rest of 2015?
HQX is looking forward to continuing to support our customers by advancing their value based strategies. This isn’t just about bundled payments. It is also about understanding the ecosystem of health and how to deliver information to all the stakeholders in order improve the quality of care while reducing costs. What excites us is that we can see how our analytic platform better enables complex care objectives that achieve those goals such as: provider network specific disease services, bundled payments, alternative provider network designs, value based provider contracts, alternative care models (e.g. ACO) and more.
What current trends in health care do you see as the most significant and what role will HealthQx play in moving the trend forward?
One of the biggest trends we’ve seen is the rapid adoption of alternative payment methodologies. Now that CMS has set aggressive goals for 50% of payments to be based on alterative payment models by 2018 we’re seeing a flurry of market activity. There is no one size fits all approach to achieving this goal. In order to do it correctly health plans and health systems need to harvest the intelligence within their four walls and beyond their four walls to create the right VBC strategy. Once the strategy is in place it takes continuous monitoring over the care continuum to ensure the value of care is being delivered to the consumer (and therefore the system at large).
We help our customers across this entire journey. From identifying high value episodes to selecting the right payment methodology through to continuous improvement – ClarityQx was built for this purpose.
How do you see this trend affecting consumers?
From the consumers’ perspective we have to take a step back to understand the ripple effect of payment changes in health care. From a high-level perspective we are moving away from a system that rewards volume, which is typically referred to as the fee for service environment, to a system that rewards the value of care delivered. As we take this a level deeper, there is an impact in the types of provider networks offered to consumers. This can take the form of a narrow network or, if we carry it out even further, it can lead into different care models such as Accountable Care Organizations (ACO). Along with these changes we’re also seeing rise of different health plan products that are being offered to consumers.
We continue to see health care costs rise and it is putting a strain on our country and consumers. Do you have any programs, initiatives or relationships in progress that aim to address or remedy this issue?
HQX is on the technology side of the health industry, we think the best way for us to contribute to solving the cost equation problem of health is by supporting health plans and health systems with their value based care objectives. For example, we’ve recently created a unique partnership in the industry where we have access to a large, longitudinal data set. We’ve been using this information to support health systems as they seek to better understand the episode of care opportunities within their populations. The long-term objective of this process is to enable these health systems to create centers of excellence for disease-specific conditions. We are also very active in the industry and seek out partnerships like the one we have with HCI3 to support research and innovation in the development of standard methodologies for the industry.
At HCI3, we are very excited to be working with HealthQx and applaud your efforts on becoming the first HCI3 ECR Analytics Certified Partner! What are your hopes and expectations from the relationship as we work together moving forward?
As an industry we’re reaching a new level of maturity within the area of value based payments. The maturity is related to the experience we’ve gained from the last 10+ years of practical experimentation of alternative payment models and the innovation within the supporting technologies. HCI3 has been part of this movement from the beginning by being an independent third party that can objectively create standards and rigorously test them to ensure statistical relevancy. This is valuable work as it provides a common foundation for important value-based constructs such as episode definitions, quality and performance measurement and cost information.
We are looking forward to continuing to partner with HCI3 as the industry continues to advance in the area of value based care.