SAN MATEO, Calif.–(BUSINESS WIRE)–Healthcare leaders at the federal, state, and healthcare organization levels are progressively shifting towards population health to address current health inequities. “A key source of today’s health inequities is social determinants of health (SDOH), such as income, race, education, and social support,” stated Dr. Douglas G. Cave, President of CCGroup.
SAN MATEO, Calif.–(BUSINESS WIRE)–The Physician Organization of Michigan ACO, LLC (POM ACO) is working with Cave Consulting Group, Inc. (CCGroup) as part of POM ACO’s efforts to provide better health at lower overall healthcare costs for approximately 100,000 Michigan Medicare beneficiaries with traditional Medicare coverage. POM ACO entered into a Medicare Shared Savings Program (MSSP) with the Centers for Medicare and Medicaid Services (CMS) to better manage these Medicare beneficiaries, focusing on higher quality, more coordinated, and less variable care.
SAN MATEO, Calif.–(BUSINESS WIRE)—John Muir Health (JMH) is working with Cave Consulting Group, Inc. (CCGroup) as part of JMH’s efforts to engage with physicians to focus on opportunities to improve efficiencies in the delivery of high quality, coordinated care to patients.
SAN MATEO, Calif.–(BUSINESS WIRE)–The National Committee for Quality Assurance (NCQA) requires health plans and other payers to meet new Population Health Management (PHM) standards for PHM 3: Delivery System Supports for accreditation. CCGroup’s advanced analytics meet these new PHM 3 standards.
SAN MATEO, Calif.–(BUSINESS WIRE)–The National Committee for Quality Assurance (NCQA) requires health plans and other payers to meet new Population Health Management (PHM) standards for PHM 2: Population Identification for accreditation. CCGroup’s advanced analytics meet these new PHM 2 standards.
SAN MATEO, Calif.–(BUSINESS WIRE)–Comprehensive Primary Care Plus (CPC+) is designed by the federal government to strengthen primary care through payment reform and care delivery transformation. The CPC+ payment design gives primary care physician (PCP) practices additional financial resources to improve quality of care and reduce the number of unnecessary services their patients receive.
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 back pain, degenerative joint disease, sleep apnea, and headaches,” stated Dr. Douglas G. Cave, President of Cave Consulting Group (“CCGroup”).
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. “Research studies showed that gatekeeper models generally were no more efficient at curtailing medical trend than non-gatekeeper plan designs. Also, large employers wanted more open access to specialist care for their employees,” stated Dr. Douglas G. Cave, President of Cave Consulting Group (“CCGroup”).
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™). Continue reading
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 or an answer on ongoing royalties.
In March 2015, a jury awarded Cave more than $12.3 million, saying UnitedHealth Group Inc. unit OptumInsight Inc’s Impact Intelligence product infringed two claims of Cave’s patent for products that try to calculate doctor efficiency and also categorize patient health risk. The jury also rejected counterclaims that Cave software infringed an Optum patent.