MEDInsights™

Participation in the National Dialogue About Quality Improvement Heart Failure Patients Receiving ACEIs/ARBs were Less Likely to be Hospitalized or to Use Emergency Care in the Following Year. Chen JY, Kang N, Juarez DT, Yermilov I, Braithwaite RS, Hodges KA, Legorreta A, Chung RS. Journal of Healthcare Quality, 2011 Does Pay for Performance Improve Cardiovascular Care in a "Real-World” Setting? Chen JY, Tian H, Juarez DT ScD; Yermilov I, Braithwaite RS, Hodges KA, Legorreta A, Chung RS, American Journal of Medical Quality, 2011. Our Findings resulted in a change in the HEDIS algorithm for Identifying Persistent Asthmatics Collaborative Work with the American College of Asthma Allergy & Immunology

Participation in the National Dialogue About Quality Improvement cont’d. Workplace health screenings were associated with a subsequent increase in physician visits and prescriptions for hyperlipidemia. Significant improvements in total cholesterol and LDL levels were observed among individuals who screened positive for hyperlipidemia. 1 year later

Identifying the Need Health Advocate formerly had to reference multiple sources when searching for physician recommendations that met our members’ needs There are no tools in the marketplace that do what we need to them to do The MEDIS tool is a proprietary, integrated analytic tool for use by our Personal Health Advocates and clinical staff, solidifying our position as “Best of Class” in the marketplace

MEDInsights™ (MEDIS) Volumetric, data-driven tool that utilizes clinical data and a unique statistical algorithm to rank providers based on a series of outcome measures. Utilizes 2 years of CMS Medicare clinical data to calculate efficiency score for physicians. Geographically diverse, clinically expansive Efficiency Score Factors: Procedure Volume Readmissions Length of Stay

Volumetrics: There is a Well-Established Correlation Between Procedure Volume and Outcomes “This study demonstrates that increased hospital experience is associated with a marked decrease in hospital mortality. The decreased mortality at the high-volume provider was also associated with shorter lengths-of-stay and lower hospital charges.” “We conclude that the current evidence strongly supports the association between increasing hospital volume with lower mortality and improved long-term survival following lung resection.” “Higher Volume (whether assessed by hospital or by physician) is associated with better health outcomes”

MEDInsights™ (MEDIS): Key Takeaways High Volume Physicians are linked to better outcomes Our efficiency and effectiveness score is built on a large, robust and geographically diverse clinical dataset. The tool enables Health Advocate to search common surgical procedures to identify physicians with highest adjusted volumes within a given area.

Data Envelopment Model (DEA) Methodology Uses 2014 and 2015 Medicare data Health Advocate’s commercial data and 2016 Medicare data will be added Ranking physicians based-on optimal performance, not the average Performance factors; procedure volume, length of stay, readmission rate. Covers 51 high frequency inpatient and outpatient procedures with more on the way

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