Supernova Award Category
The Problem
On January 31, 2013, the Centers for Medicare & Medicaid Services (CMS) announced the health care organizations selected to participate in the Bundled Payments for Care Improvement initiative, an innovative new payment model. Under the Bundled Payments for Care Improvement initiative, organizations will enter into payment arrangements that include financial and performance accountability for episodes of care. These models may lead to higher quality, more coordinated care at a lower cost to Medicare.
Under the Bundled Payments for Care Improvement initiative, organizations will enter into payment arrangements that include financial and performance accountability for episodes of care. As a result, Remedy’s customers needed to ensure they were providing superior care in order to maximize payment.
In order to do this, Remedy needed a way to bring together all of their clients’ disparate data and visualize it in a single view in real time for our customers.
The Solution
Since hospitals are measured and paid based on patient outcomes, it’s important they establish and embed benchmark data into their daily workflow in order to continuously improve quality, efficiency, patient safety and satisfaction. Remedy manages patient care data across multiple sources, including MongoDB, MySQL, CSV (Medicare FTP monthly and quarterly 19 claims files). Also we maintain our own data center and use a number of technologies. With that said, we needed a way to bring all of these data sources together in real time so our customers can visualize this information. We became familiar with Pentaho first through their community edition. After that, we decided to purchase their enterprise edition since it provides Remedy with a scalable platform to incorporate multiple disparate data sources that will continue to grow in size. For example, CMS data will continue to grow so we need to ensure we can handle growing data volumes as we bring on more customers.
The results
Our product – Episode Connect – has differentiated itself from other platforms and tools because it supports nearly every care improvement effort and a variety of important processes from administration to care coordination. The beauty of Episode Connect is that it quickly adapts to existing systems and care delivery preferences while eliminating costly workflow redundancies.
What is interesting about our offering is that we have identified 270,000 patients for bundled payment programs since 2011 while driving savings of over $250,000 per day by providing CMS with increased program visibility – this is because of our ability to fully integrate with over 900 healthcare provider systems, such as hospital systems and EMRs.
Metrics
Our platforms for managing bundled payment programs are saving over $250,000 per day, while improving quality of care for hundreds of thousands of Americans. We are able to do this based on the analytics that we are able to provide on our patients that include:
- # of episodes
- Episodes with a readmission to a hospital
- Episodes contacted after acute stay
- Spending per category
The Technology
Pentaho Data Integration and Pentaho Business Analytics
Disruptive Factor
Remedy Partners is integrated with over 900 healthcare provider systems, such as hospital systems and EMRs, in order to collect operational patient episode data like admissions and discharges. Healthcare providers frequently use several disparate systems internally to manage patient data which rarely talk to one another which creates a data integration challenge as fragmented patient information is spread across various systems. Since the program is data driven, it has had a major impact on our organization, as it requires the ability to track the patient in a bundle and measure the outcomes. It is important to get real-time data for patient identification and attribution to the responsible provider so bundle and care coordination can happen at the right time. Possessing an aggregated longitudinal and real time view of the patient allows for analytics and reporting that is not easily available allowing for greater decision support and insight development. Now, providers are engaged in a new alternative way to pay for healthcare (bundle payments) and changing workflows and behavior at the point of care to better manage outcomes of patients in a more cost effective way. Since Remedy has deep human capital experience managing episodes of care, the team has been able to deliver an end-to-end bundle payment technology solution and a data view which allows for insight potential not easily available to healthcare providers and payers.
Shining Moment
Remedy Partners is a great example of a company that is able to address the changing healthcare environment by providing hospitals with real time data to improve quality of care, efficiency and operations. We take this responsibility seriously as Remedy helping someone’s mother, brother, father, sister, friend or other relative.