Rather than take on too many delegated responsibilities at once, some physician organizations adopt a hybrid model: They assume medical management while continuing with the health plan’s contracted network, and the plan continues to pay claims, providing reports to the medical group. But this arrangement can lead to critical data gaps because provider agreements require that rates remain confidential.
The result: Redacted behavioral health and other utilization information, plus summary reports with little utility at the patient level or lacking unit costs, according to our Physicians Practice article Overcoming the data hurdles impeding medical management and risk. It leaves practices flying blind.
One solution for getting the detailed information needed to succeed is to partner with a health data analytics firm. These firms can produce actionable and timely information while preserving the obligation to confidentiality. Read the full article, detailing the problems and solution.
For more information about pursuing medical management or the benefits of data analytics as a service, please contact us at email@example.com.