Supporting Providers Making Care More Affordable Care

A better health system will give providers the tools to deliver high quality, lower cost care.

Managing the details is impossible if one can’t see the whole picture. Often, providers do not have a global view of their practice, much less the ability to benchmark themselves to their peers locally and across the nation. Actionable data enables providers and practitioners to make adjustments in treatment patterns that could result in more efficient use of health care resources and spending.

Total Cost of Care Project

In partnership with the Network for Regional Healthcare Improvement (NRHI) and funded by the Robert Wood Johnson Foundation, CIVHC is in its third year of collaborating with six states to establish standard ways of investigating variations in health care costs and resource use.

Through this project, CIVHC provides reports to over 100 Colorado-based adult and pediatric primary care practices that include information on the total cost to treat patients annually and what portion of costs were driven by volume of services vs. prices. The information on price, utilization and total cost is broken down by inpatient, outpatient, professional and pharmacy services to give physician groups a better idea of the types of services driving their results. All results are risk adjusted based on the health status of attributed patients to address the concern that one physician practice may treat a “sicker” group of patients thereby allowing meaningful comparisons of utilization (Resource Use) and total costs.

The scatterplot shows where medical service use (RUI) and the prices paid for care (PI) of participating practices fall in relation to other practices and the statewide average. The intersection of the horizontal and vertical lines indicates the statewide average for both measures. High performing practices will have low values for both price index and resource use and occupy the lower left quadrant.

As one of seven states participating in this project, Colorado has a lot to gain from the analysis. This information is invaluable as it provides physicians with data they’ve never had which helps them identify ways they can lower costs and improve care for their patients.

Total Cost of Care Webinar

In December 2016, CIVHC hosted a webinar for the practices participating in the Total Cost of Care project. Jay Want, MD, and Jonathan Mathieu, PhD walked attendees through the different interactive reports and provided valuable context to the data. Click to view a recording of the webinar or here to view the slides from the presentation.