CCS Advantage program's performance measures validated by Milliman

Sep 18 2009

MedAssurant, Inc., a leading provider of data-driven healthcare solutions, announced today that Milliman, Inc., has validated the calculations of several performance measures for MedAssurant’s CCS Advantage™ program, and confirmed the calculated values of medical cost for Medicare patients with chronic illness in the study population. At a time of intense pressure for managed care organizations to control medical expenses, these results are supportive of MedAssurant’s unique approach to disease management.

The program, launched in 2007, 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 empowers 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 enables rapid, meaningful, and measurable impacts in engagement, clinical outcome, compliance, utilization, and overall costs.

Milliman’s report examined the accuracy of the calculated costs used for comparison of a specific health plan’s cohort for their Medicare Advantage patients who were engaged in the CCS Advantage™ program in 2007 and 2008. Comparing costs for those patients for the seven months after their individual engagement to their historical costs for seven months pre-engagement, and applying the same calculations as used by MedAssurant, the Milliman report validates the accuracy of MedAssurant’s calculations:

• An overall reduction of 9.5% in per member per month (PMPM) costs for all patients engaged in the program; and
• Reductions in line item costs, ranging from 8.8% to 12.9%, for professional costs, laboratory costs, and inpatient costs.

“Milliman has evaluated the results of MedAssurant’s calculation of the metrics on Medicare Advantage data for the four CCS Advantage™ performance measures, and found that the calculation of the measures was substantially accurate,” said Richard Kipp, MAAA, Principal, Consulting Actuary, and lead author of the report. Additional analysis showed that for the rest of the health plan’s Medicare Advantage patients not engaged within the program, costs increased an average of 7.5% over the similar time period.

“Evaluating the impact of a disease management program on costs can be a complicated undertaking,” said Cary Sennett, MD, PhD, MedAssurant’s Chief Medical Officer. “Through achieving full accreditation for CCS Advantage™ from the National Committee for Quality Assurance (NCQA), achieving results certification through the Disease Management Purchasing Consortium (DMPC), and now by turning to Milliman, Inc. to report on the calculation of our cost savings results, MedAssurant has sought to demonstrate not only the performance of the CCS Advantage program, but also a corporate commitment to results transparency.”

“Taking a highly data-driven approach to care management and coordination has been a core mission at MedAssurant,” said Keith Dunleavy, MD, MedAssurant’s President and CEO. “We believe that advanced analytics combined with a personal approach to patient-specific granularity enables a more powerful insight into what is needed and how it should be achieved. Thereafter delivering impact through a hybrid combination of informed paper and telephonic outreach, together with targeted in-market, personal contact, makes a material difference for our clients and their members. These results corroborate what other analyses have shown—that CCS Advantage™ materially improves outcomes - and meaningful cost savings follow.”