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

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

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

“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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