March 17, 2017
iStock_000004839396-Thumbs-up-woman-Medium

“Targeted Gatekeeper Model” Provides High Return on Investment Through Improved Patient Cost and Quality of Care

SAN MATEO, Calif.–(BUSINESS WIRE)–Primary care physicians (PCPs) need to become more active participants in treating medical conditions with significant practice variations. “Currently, PCPs are involved in treating only 40% of the top 10 medical condition episodes of care with the most practice variations. Some of these medical conditions include low […]

February 17, 2017
Targeted Healthcare

“Targeted Gatekeeper Model” for Specialist Referrals Gains Momentum Under Accountable Care and Value-Based Reimbursement

SAN MATEO, Calif.–(BUSINESS WIRE)–In the 1980s and 1990s, health plans and other payers depended on primary care physicians (“PCPs”) to be the gatekeeper for referrals to specialists. Covered members were required to select a gatekeeper in order to receive medical coverage. This gatekeeper model was not successful for several reasons. […]

November 15, 2016
Medicine team

Leading Health Systems Move Forward in the Development of Quantitative Clinical Pathways

SAN MATEO, Calif.–(BUSINESS WIRE)–Nationally over 230,000 primary care physicians (PCPs) and specialists are evaluated based on achieving acceptable clinical protocol ranges in treating medical conditions (or Clinical MedMarker Protocol Ranges™).    “MedMarkers™ are process of care quality measures that are the key services associated with cost-of-care in treating a medical […]

October 11, 2016
Intellectual_Property

Court Upholds $12M IP Infringement Verdict

Law360, New York (September 7, 2016, 7:29 PM EDT) — A California federal judge refused Wednesday to overturn a $12.3 million jury verdict against a UnitedHealth unit found to have infringed a patent for technology that measures doctors’ efficiency — but also refused the victorious plaintiff, Cave Consulting Group LLC, an injunction […]

October 6, 2016
pcps

Primary Care Physicians Can Better Manage the Total Cost of Care for an Accountable Care Population

SAN MATEO, Calif.–(BUSINESS WIRE)–Primary care physicians (“PCPs”) can more effectively manage the total cost of care when managing the healthcare needs of a covered population. Cave Consulting Group (“CCGroup”) reached this conclusion after evaluating the performance of several health plan accountable care and value-based reimbursement programs.   “On average, PCPs […]

May 16, 2016
medical-specialists

National Specialist Panels Uphold Established Clinical MedMarker Protocol Ranges™

SAN MATEO, Calif.–(BUSINESS WIRE)–Nationally over 230,000 primary care physicians (PCPs) and specialists are evaluated based on achieving acceptable clinical protocol ranges in treating medical conditions (or Clinical MedMarker Protocol Ranges™). “CCGroup works with CCGroup National Specialist Panels on an ongoing basis. This effort helps to ensure the validity of established […]

April 1, 2016
Checking money status.

Foundation for Successful, Provider Value-Based Payment Programs

SAN MATEO, Calif.–(BUSINESS WIRE)–CCGroup is the market innovator and leader in reliably measuring physician efficiency. Just one year ago, a California federal jury awarded Cave Consulting Group, Inc. (CCGroup) more than $12 million after determining that OptumInsight’s Impact Intelligence infringes CCGroup’s patent for measuring physician efficiency. “No other competitor to […]

May 13, 2015
Healthcare-Compliance

CCGroup Seeks Injunction Against OptumInsight’s Impact Intelligence Software

SAN MATEO, Calif.–(BUSINESS WIRE)–A California federal jury determined that UnitedHealth Group’s subsidiary OptumInsight infringed Cave Consulting Group’s patent for measuring physician efficiency. The federal jury determined that OptumInsight infringed the U.S. Patent No. 7,739,126 (“‘126 patent”) by operating and licensing its Impact Intelligence software, a competing solution for developing physician efficiency scores. “The jury […]

April 8, 2015
Intellectual_Property

Jury Awards Cave Consulting Group $12 Million for Patent Infringement

SAN MATEO, Calif.–(BUSINESS WIRE)–A California federal jury on Friday, April 3, 2015 awarded Cave Consulting Group, Inc. more than $12 million after determining that UnitedHealth Group’s subsidiary OptumInsight infringed Cave Consulting Group’s patent for measuring physician efficiency. The jury also rejected OptumInsight’s counterclaim that Cave Consulting Group infringed OptumInsight’s patent […]

April 30, 2014
patent-seal

Cave Consulting Group, Inc. Prevails In Numerous Patent Infringement Disputes With OptumInsight, Inc.

SAN MATEO, Calif.–(BUSINESS WIRE)–CCGroup is pleased to announce that it has prevailed on many of the patent infringement claims asserted against it by OptumInsight (formerly Ingenix, Inc.). OptumInsight’s claims of infringement for 6 of its 8 asserted patents, which pertained to grouping medical claims data into episode treatment groups (“ETGs”), have […]

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