Category: Uncategorized

Western Region Health System Works with CCGroup to Improve Clinically Integrated Network Efficiency and Reduce Losses on Capitation Arrangements
By devadmin

Western Region Health System Works with CCGroup to Improve Clinically Integrated Network Efficiency and Reduce Losses on Capitation Arrangements

SAN MATEO, Calif.–(BUSINESS WIRE)–Cave Consulting Group, Inc. (CCGroup) is working with a Western Region health system to improve the efficiency of the system’s clinically integrated network (CIN). “Our client’s CIN was built on quality and access to deliver healthcare to 170,000 capitated ACO REACH and Medicare Advantage patients,” stated Dr. Douglas G. Cave, President of CCGroup. “Little attention was paid to specialists’ efficiency in managing to a global budget – until losses began mounting over several years.”

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CCGroup Clinical Decision Support System Quantifies “COVID Effect” on Decreased Healthcare Utilization in the United States
By devadmin

CCGroup Clinical Decision Support System Quantifies “COVID Effect” on Decreased Healthcare Utilization in the United States

SAN MATEO, Calif.–(BUSINESS WIRE)– Cave Consulting Group, Inc. (CCGroup) initiated this study to quantify the COVID Effect’s impact on decreased U.S. healthcare utilization. Decreased utilization is a function of at least two components: (1) decreased volume of medical condition episodes seen by PCPs and specialists; and (2) decreased volume of key medical services (MedMarkers™) used to diagnose and/or treat those medical condition episodes that are seen by PCPs and specialists. “We examine here only the initial component, decreased volume of medical condition episodes,” stated Dr. Douglas Cave, President of CCGroup.

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Is Kaiser Permanente Health Plan More Efficient Than Competing Blue Cross Blue Shield Health Plans and Regional Health Plans?
By devadmin

Is Kaiser Permanente Health Plan More Efficient Than Competing Blue Cross Blue Shield Health Plans and Regional Health Plans?

SAN MATEO, Calif.–(BUSINESS WIRE)–Cave Consulting Group, Inc. (CGroup), the market leader in reliably measuring physician and health system efficiency for several decades, is answering this question using results from the company’s Centers for Medicare & Medicaid Services (CMS) Innovator Project. The CCGroup Innovator Project allows access to all Medicare fee-for-service (FFS) and Medicare Advantage (MA) claims through the CMS Virtual Research Data Center (VRDC) – including all acute care, post-acute care, physician visits, physician procedures, and pharmacy services for more than 60 million individuals each year. This includes all 50 states and the District of Columbia.

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A National Healthcare Predicament: Most PCPs Are Not Involved in Managing the Top 10 Medical Conditions with Significant Practice Variations
By devadmin

A National Healthcare Predicament: Most PCPs Are Not Involved in Managing the Top 10 Medical Conditions with Significant Practice Variations

SAN MATEO, Calif.–(BUSINESS WIRE)–Primary care physicians (PCPs) need to become more active participants in treating the Top 10 medical conditions with significant practice variations. “Nationally, PCPs are solely involved in treating less than 25% of medical condition episodes with the most practice variations,” stated Dr. Douglas G. Cave, President of Cave Consulting Group (CCGroup). “And these medical conditions – such as low back pain, degenerative joint disease, headaches, sleep apnea, cataracts, and heartburn – drive well over 50% of all potential patient cost and quality improvements.”

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“Targeted Gatekeeper Model” Needed for Successful CPC+ Payment Reform and Delivery Transformation
By devadmin

“Targeted Gatekeeper Model” Needed for Successful CPC+ Payment Reform and Delivery Transformation

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.

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