Value-Based Care Delivery and Payment Models
Understand the clinical and financial aspects of episodes of care
Analyzing, understanding and managing episode-based care information is an integral part of the transition to value-based payment and care delivery. These new care and payment models require a new set of sophisticated analytic tools that help ensure that all stakeholders have a complete understanding of current performance, as well as an ability to confidently predict and manage the financial and clinical risks and rewards associated with contracting for value.
" An Evidence-informed Case Rate, or ECR® , is a budget for an entire care episode that includes all covered services bundled across all providers that would typically treat a patient for a single illness or condition. It is adjusted for the severity and complexity of each patient's condition."
How SAS® Can Help
To make an impact in helping the health care industry, SAS and the Health Care Incentives Improvement Institute (HCI3) – a leader in bundled payment methodology – have developed an advanced analytics solution to address emerging provider reimbursement models.
Based on the principles of HCI3's earlier, groundbreaking PROMETHEUS Payment® ECR (Evidence-Informed Case Rate) Analytics system, SAS® for ECR Analytics™ allows organizations to better understand care delivery patterns at a more holistic level than ever before. By enabling providers to understand how to gain efficiency, manage patient care and negotiate with payers, this solution will become the new standard for the health care industry. With SAS, you can:
- Gain efficiency in care delivery. SAS gives you clinically validated definitions of relationships between episodes to gain a broader level of insight beyond an individual episode. Now you can have a comprehensive view of how patient care has been delivered across a wide variety of conditions and procedures, including clinical practice variation for populations.
- Manage patient care through increased collaboration. SAS helps you better understand the state of a patient's overall health, including comorbidities, and all the providers involved in care delivery. With this information, you can actively manage patient care through increased collaboration to ensure better outcomes, increased efficiency, reduced costs and improved value to the patient.
- Negotiate with health plans. By gaining insights into care delivery, cost of care and outcomes, you are better positioned to negotiate with health plans for all contracts.
How SAS® Is Different
- A proven solution. SAS has enhanced HCI3’s proven PROMETHEUS Payment solution through better performance and reporting, as well as through improved risk models and advanced analytics.
- A holistic view of the patient. SAS helps you understand the complexities of managing a patient, as well as the potential variations that lead to complications. By analyzing the interrelationships created between episodes and episode classes, you can understand and craft new approaches to addressing the underlying reasons for variations.
- Ensured data integrity. Because SAS provides built-in quality assurance through its data integration technology, you have better assurance in the quality of incoming data.
- Speed and ease of deployment. Using the software-as-a-service (SaaS) model improves time to value, is highly secure, provides a scalable architecture and allows you to quickly gain advantages of new releases.
- More, refined episodes. SAS for ECR Analytics includes more than 30 ECR episodes – from individual procedures such as joint replacements to treatment of chronic conditions such as diabetes and cardiovascular disease, with more episodes being added in periodic updates.
Related Products and Solutions
SAS® for ECR Analytics™
As the health care industry adopts value-based models, providers need to analyze episode-based patient care and attendant costs from granular to holistic levels. SAS provides a set of sophisticated analytic tools that give all stakeholders a complete understanding of current performance, as well as an ability to confidently predict and manage the financial and clinical risks and rewards associated with contracting for value.
Ready to learn more?
Call us at 1-800-727-0025 (US and Canada) or request more information.