EVIDENCE BASED QUALITY CARE

Case Study

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Not all care is created equal!

Seamless Integration Clinical Intelligence Analytics

Our patented software program ranks providers on quality for chronic illnesses (severity adjusted) and episodic procedures using 300+ QIs on a customizable platform for editing/adding QIs. 

The program optimizes referral management and network value by connecting patients with specific illnesses to high performance providers "within your network" demonstrating superior price efficiency and quality outcomes for specific illnesses and procedures. 

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This allows creation of disease-specific "in network" providers based on quantifiable data from multiple credible sources supporting its rankings and providing original source documentation.

The program extracts information from dozens of sources including claims data, EHR data and third party data from dozens of sources to generate provider scoring and rankings with unique software. 

Few people are aware of the cost and dangers of low quality care. We are here to highlight the issues faced today surrounding unprecedented advice.

We focus exclusively on improving patient outcomes at a lower cost by clinically identifying  high performance accountable physicians within your existing network. 

This drives efficiency for the employer and effectiveness for the employee by providing the most appropriate care defined by high performance physicians that have the best track record of using evidence based outcomes best practices, all within your existing network.

Low quality providers drive high costs and poor outcomes for patients. we seamlessly align the interests of doctors, patients, and employers. Quality Outcomes are achieved by having clinical data for providers (within your existing network) with the safest, most effective high performance healthcare providers delivering best practice care using the patented technology.

Patients receive better functional outcomes faster by prioritizing best care paths and avoiding harmful, aggressive and unnecessary procedures Through avoidance of expensive surgery & procedures, the cost of care is lowered significantly saving the employer money. 

Additionally the employee recovers faster and can resume work more quickly. We can establish a  solution for you within 12 weeks with agreed measurable success outcomes to achieve: 

• Employees receive better outcomes
• Reduction in the overall cost of care 
• Faster employee return to work 
• Lower rates of employee disability  

What are the benefits of high performance providers? Cost reduction ,Healthy outcomes: 

Quality based care focuses on recovery, which ultimately results in less spending and healthy employees. 

Imagine you’re managing a chronic disease such as diabetes, high blood pressure, cancer or obesity — this could not only be time and energy-consuming, but it can also end up costing a lot of money. 

Quality /Value based care programs can easily manage these conditions, or in some cases, avoid them altogether. You're employees may require fewer medical visits, procedures, and tests and more affordable medications. 

Increased employee satisfaction: Quality of healthcare improves when the focus is on value instead of quantity, and on prevention rather than chronic disease management. 

Generally, Quality/value-based care programs result in higher overall employee satisfaction with healthcare plans.  

Overall reduction in medical errors: Quality/Value-based care can help reduce medical errors. Medical errors are a top concern among plan sponsors (e.g., large employers), who have realized that much of their spending goes toward treatments that are unnecessary, harmful or ineffective.

Consequently, more employers are turning to quality/value-based care to reduce medical errors. 

Society becomes healthier overall: 

With quality/value-based care, society generally becomes healthier, and at a lower cost. Hospitalizations and medical emergencies would decrease and less money would be spent on managing chronic diseases. As a result, overall healthcare spending costs are reduced.

Our Clinical software can seamlessly be used to track physician adherence to evidence-based best practices and outcomes. Managing order sets and medical knowledge with clinical software can provide decision support for physicians. To monitor physician adherence to evidence-based medical practice. outcome metrics include length of stay, morbidity, mortality, and readmission.

ONE EXAMPLE:

MUSCULOSKELETAL CARE

In the US, 40% of employees who undergo spine surgery experience chronic pain and pain-related disability long after the procedure, and 44% are more likely to become dependent and prolonged opioid users as a direct effect of the surgery. 

Choosing the right doctor at the outset has a ripple effect on the employee's outcomes and quality of life. this impacts their families, employers, community, and society at large. Currently, there is no unbiased or systematic process in place to help guide employees when making the important decision of choosing a doctor. 

This is made all the more difficult in the face of the multibillion-dollar industry that profits from excessive opioid use and aggressive procedures that result in $2-8.5 billion of needless spending every year. 

We believe the physicians who go above and beyond for their patients should be recognized and rewarded for their patient-centered, value-based care, which correlates with better patient outcomes and a lower total cost of care.

Our approach contrasts with today’s established trends of providing care via discounted networks, in which clinicians are compensated at a lower rate for providing treatment. This drives clinicians to promote a higher volume of lower-quality care, which can expose patients to more aggressive and expensive procedures, increasing their risk for poorer outcomes.

The US healthcare system needs a way to identify outstanding doctors, reward them for doing the right thing, and empower them with access to best practices guidance.

At the core of a healthcare system, patients seek medical care to improve their quality of life, physicians strive to provide high-quality care while retaining autonomy and compensation, and employers work to lower the overall associated cost. 

We can help align the interests of all three parties by not only achieving each of their goals but having a high-tech network that enhances this complex interplay of factors and improves the healthcare system as a whole. 

Don’t let one bad decision determine the outcome of your employee's quality of life. we would love to tell you more about how we can help your organization, so don’t hesitate to reach out for more information. 

As mentioned above, we can establish a solution for you within 12 weeks with agreed measurable success outcomes to achieve:  Reduction in the overall cost of care Faster employee return to work  Lower rates of employee disability and opioid dependency

• We will be happy to provide, with a "no cost review" forecast of cost savings and patient improved function based upon analysis of your claims data.

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