MedAssurant announces certification of event rate outcomes for HIP Medicare Advantage patients

Aug 21 2009

MedAssurant, Inc., a leading provider of data-driven healthcare solutions, announced today that the Disease Management Purchasing Consortium (DMPC) has certified the event rate outcomes for HIP Health Plan of New York (HIP) Medicare Advantage patients. The results show a double-digit event rate reduction which was achieved through a program powered by MedAssurant’s CCS Advantage™ disease management solution.

In 2007 MedAssurant teamed with HIP to develop a bold new approach to disease management. The initiative was designed around a highly data-driven appreciation of the individual patient in combination with a hybrid of targeted, patient-specific communications together with high-touch, in-market patient interaction. Advanced data analytics and a broad technological infrastructure empowered a highly customized approach to each patient’s assessment, communication, and care plan design. Being able to identify, stratify, and respond to the uniqueness of each patient’s disease and life situation enabled rapid, meaningful, and measurable impacts in engagement, clinical outcome, compliance, utilization, and overall costs.

“Being able to identify and report on the impact of distinct disease management program interventions is critical to industry-wide evaluations, but the methodology of performing such evaluations is also quite important,” notes Al Lewis, President of the DMPC. “MedAssurant has shown its commitment to use industry best-practice methods of impact measurement, and to make its methodologies transparent to its customers and the public, by turning to the DMPC to certify the impact on event rates of its program conducted for HIP. We are pleased that MedAssurant has committed to industry standards of calculation in the certification of their impact. In our experience, MedAssurant’s data-driven approach to a patient-specific disease management program is unique, and I must say that the HIP results are by far the most impressive in the tri-state area and among the most impressive in the country.”

DMPC has certified the event rate reduction achieved by HIP over a number of time intervals during which it used the MedAssurant CCS Advantage™ offering. Using DMPC’s methodology standards, a significant reduction in disease-specific inpatient events was seen within the Medicare patient population eligible for the program:

• For heart failure (CHF) and diabetes (DM) patients, a 15.3% decline in inpatient events was seen in the first twelve months following implementation of the CCS Advantage™ disease management program (over the preceding twelve-month period); and
• For coronary artery disease (CAD) patients (a program introduced January 1^st, 2008), a 20.9% decline in inpatient events was seen in the first three quarters of 2008 (over the same period in 2007).
• Similarly positive result patterns were noted in the examination of full-year (i.e., 12 month) periods and partial (i.e., nine month) year-over-year periods in all diseases managed with positive “time dose dependence” trends suggesting continued expansion of improvement in the setting of longer program engagement and involvement.

“EmblemHealth supports its practitioners in the care and wellbeing of its members in a number of ways and we always seek programs that embrace measurement and a commitment to external validation of methods,” said Dr. William Gillespie, SVP and Chief Medical Officer of EmblemHealth. “We are firmly committed to continuously improving the quality and cost-effectiveness of care delivered to our Medicare beneficiaries and we are pleased with the results of our working together with MedAssurant.”

“CCS Advantage™ is a unique solution to the problems of care management with respect to quality, outcomes, and costs” notes Cary Sennett, MD, PhD, Chief Medical Officer of MedAssurant. “CCS Advantage™ combines MedAssurant’s advanced analytics - which provide uniquely granular and detailed insights into the facts of each patient’s case - with MedAssurant’s broad outreach, touch, and response infrastructure. Combining this patient-specific, personalized approach with an ability to cover the patient’s needs in print, by telephone, and in-market makes a material difference. The results show in patients’ comments, outcomes, and cost savings.”