Creating, Connecting And Supporting Active Consumers

Abstract:  Programmes to turn patients into active consumers have not yet lived up to their sponsors’ expectations. While the business case for such programmes has been strong, their success has been hampered mainly by two factors. The first is a…

January 31, 2017

Data for BPCI Study

December 28, 2016

State Report Card on Transparency of Physician Quality Information

This State Report Card on Transparency of Physician Quality Information, now in its fourth year of publication, assesses the breadth and substance of clinician quality information available in each state. Patients, advocates, payers, and clinicians who value quality transparency can…

November 29, 2016

First-Year Results of a Pilot Effort at a Nonprofit Medicaid HMO in Texas

A Case Study

HCI3 collaborated with CHC to design, implement, and measure a bundled payment program for maternity care, and the experience—both during the process of executing year one of the pilot, and upon review of the first year’s outcomes—yielded insights valuable to…

October 20, 2016

Identifying Sources of Variation in Asthma Episodes of Care with PROMETHEUS Analytics©

Issue Brief: Asthma

Focusing on improving care holds the potential to save money for payers and ultimately improve patient outcomes.A critical step toward those dual goals is to identify variation in the cost and quality of asthma care, and isolate opportunities for improvement.…

October 11, 2016

The PEBTF Total Joint Bundled Payment Pilot

A Best Practices Summary

Sixty-nine patients took part in PEBTF’s yearlong bundled payment pilot and the experience yielded meaningful lessons, described in detail throughout this case study. Under the bundled payment program for total hip and total knee replacements: The hospital facility and orthopedic…

August 30, 2016

Best Practices to Maximize Consumer Use of Transparency Tools

Issue Brief: Health Care Price Transparency Tools

The benefits of transparency are only realized if consumers attend to and use the information in making choices. We know from years of experience and decades of research with health care quality transparency efforts, that the way in which information…

August 11, 2016

Medicaid Maternity Outcomes

August 4, 2016

Average Price and Complications Rates for Hysterectomies in NH, by Hospital

July 28, 2016

Report Card on State Price Transparency Laws – 2016

Dear Colleagues, We are happy to announce the fourth installment of the Health Care Incentives Improvement Institute (HCI3) – Catalyst for Payment Reform (CPR) Report Card on State Price Transparency Laws.The health care leaders who have been following our report…

July 26, 2016

Which Is The Best Provider

July 15, 2016

When is the Most Popular Procedure the One with the Worst Outcomes?

Issue Brief: Hysterectomies

There is a popular myth that laparoscopic surgery is always safer than regular surgery because it reduces the potential for wound infections and complications associated with longer lengths of stays. In many instances, that myth is validated. However, for this…

July 11, 2016

An Overview of the Risk Adjustment Methodology for PROMETHEUS Analytics

White Paper

PROMETHEUS Analytics© is perhaps the most comprehensive system available for analyzing provider performance, and developing and implementing value-based payment models around episodes of care. A critical feature of any episode grouper is the application of appropriate methods of risk adjustment…

May 15, 2016

Identifying Sources of Variation in Diabetes Episodes of Care with PROMETHEUS Analytics

Issue Brief: Diabetes Care across the Country

Uncovering any inefficient spending or low-quality care associated with as prevalent and costly disease as diabetes holds the potential to save money for payers and improve outcomes for patients. A critical step toward those twin goals is to identify variation…

March 25, 2016

Nation’s Largest Commercial Value-Based Healthcare Program Delivers on Triple Aim

Case Study: Horizon Healthcare Services

Even before the Affordable Care Act, Horizon Healthcare Services of New Jersey set out to change how healthcare is delivered. A few years into its initiative, the company runs the largest commercial Episodes of Care (specialty-value-based) program in the country,…

February 4, 2016

Developing a State-based Quality Measurement Program Using an Episode-of-Care Framework: Recommendations for State Purchasers

Introduction As the US health care system moves towards value-based payment, it becomes clearer that, while alternative payment models are important, the underlying information processes required to vivify these new payment models are equally critical to the success of the…

December 1, 2015

Piercing The Darkness: A Generalizable Approach To Reliably Measuring Quality Of Care

To help all states significantly improve their grades and provide important quality information on physicians, we have developed a rigorous methodology to calculate outcomes of patient care. The methodology is detailed in this companion White Paper to the Report Card.…

November 17, 2015

State Report Card on Transparency of Physician Quality Information

For a third year in a row most states receive a failing grade for providing information to consumers on the quality of physician care. While national attention has been placed on price transparency, a commensurate spotlight has not been shone…

November 17, 2015

Reconciling ASO Bundled Payment Contracts in a Multi-Employer Setting

Bundled Payment: Why Employers Should Care Since the passage of the Employee Retirement Income Security Act (ERISA) in 1974, many employers, especially larger ones, have turned from the costlier practice of purchasing health benefits from health plans in state-regulated marketplaces.…

October 30, 2015

Health Information Technology in the United States, 2015

Why Payment Reform and HIT Interoperability Must Follow the Same Innovation Route

In the January 2007 issue of the Journal of Healthcare Information Management, we argued that the American health care system is “a dark, lumpy archipelago composed of tens of thousands of isolated corporate islands that, at least in terms of …

September 17, 2015

Measuring Provider Performance

PAC Rate Performance Measurement

July 22, 2015

Modes of Payment Discourage Information Sharing

Relationship Between Payment and Information Sharing

April 16, 2015

Getting Accurate Price Estimates from Price Transparency Tools

For millions of Americans, health care is increasingly becoming a retail market. More than one in five Americans with private insurance is enrolled in a high deductible health plan. According to the 2014 Kaiser Family Foundation survey of health care…

February 5, 2015

The Medical Cost “Sweet Spot”

The Core of Specialty Demand

October 17, 2014

Change in Health Plan Enrollments

The "One-Stop" Medical Experience Fails to Gain Traction

October 17, 2014