Introduction to the Rush 2.0 blog.
Much like the healthcare industry, The RUSH GROUP, LLC had been undergoing an evolution over the past several years. We felt it was time to recognize our evolution with a new name and a new web-site that better reflects the scope of work that we do and the value we provide our clients.
Scope of Work
Our scope of work has expanded with the increasing need to understand the health risks and needs of patients. Our work integrating systems and streamlining workflows has crossed into the clinical realm. For example, we have been working with our clients to enhance the clinical data captured in electronic medical records (EMRs) and to develop reporting solutions that enable them to get the insights needed to manage their patients and better serve their physician partners and the market.
Health Risk + Capitation
Understanding the health risks of patients is critical especially for those assuming financial risk under capitation agreements. A colleague recently spoke with me because he is having trouble getting the data needed to develop a capitation model for a provider client. His client did not have the needed data and the payers involved were reportedly, not incentivized in this particular situation to share their data. So we spent a few minutes talking about alternative data sources that could be used to uncover the risk of a population.
Alternative Data Sources
Having done market research on the causes of rare and complex cancers, I recalled that there are basically four environmental factors that increase cancer risk. As a physician, he concurred that obesity, smoking, drinking and exposures to toxins (i.e. working with or being exposed to chemicals, radiation etc.) are the main environmental factors that increase the risk of cancer and cause or contribute to other medical conditions. So we proceeded to talk about the potential for using other types of market data reflective of the four environmental factors such as spending per capita on fast food restaurants that could be correlated with the provider’s data to estimate the risk. He liked the ideas and declared that we were on our way to starting Capitation 3.0.
Reliable Data + Payment Models
Regardless of whether Capitation 3.0 becomes a reality, we know that providers today need better methods, tools and reporting systems that provide the reliable information needed to thrive as new payment models emerge and healthcare consumerism becomes a reality.
I hope you will join the conversation on Rush 2.0 and share your ideas, experiences and insights on this topic as well as others that will help advance the business of healthcare.