Health systems to access payor and provider data to support new care delivery models and improve population health

Premier healthcare alliance and Verisk Health join forces to help hospitals and health systems better assess quality, utilization and cost of care

Waltham, MA - The Premier healthcare alliance and Verisk Health, a leader in risk management solutions to the global healthcare industry, have joined forces to offer data solutions to help hospitals and health systems better define, measure and improve the health of their communities.

“To appropriately take responsibility for the health of a population, providers need a complete look at the cost and effectiveness of all care provided,” said Keith J. Figlioli, senior vice president of healthcare informatics for Premier, a provider owned performance improvement alliance of more than 2,500 U.S. hospitals and 81,000-plus other healthcare sites.

“Today most hospitals are only able to measure the procedures they perform,” Figlioli continued. “All other aspects of a patient’s health – including primary care, post-acute rehabilitation and the patient’s return to health – remain a mystery. Combining data from inpatient and outpatient settings with claims data will help produce actionable information that supports care interventions to help ensure patients receive the most effective and informed treatments possible.”

The newly formed initiative combines Premier's clinical, financial and operational comparative database – the nation's largest compilation of inpatient data containing nearly 20 percent of all U.S. hospital discharges – with Verisk Health’s risk-based analytics that are used by more than 450 healthcare organizations. As a result, providers will have access to a more complete picture of patients and a better understanding of outcomes and total cost of care, including care provided outside the hospital setting.

“By combining the significant capabilities of these two companies, providers can design and implement quality-based programs and interventions to drive cost-effective care at both the patient and population levels,” said Mike Coyne, CEO of Verisk Health. “These data-driven, risk-management initiatives are a crucial first step toward improving the national well-being and reducing costs associated with gaps in care, uncoordinated service delivery, and preventable procedures, readmissions and emergency department visits.”

This Premier–Verisk Health initiative will also enable providers to more effectively support emerging care-delivery models through health reform. For example, as hospitals and health systems participating in accountable care organizations (ACOs) are reimbursed based on performance and total cost management, they will need to collaborate with payors to efficiently and cost-effectively deliver improved outcomes, as well as exchange population-level data. This initiative will equip the ACOs with the tools necessary to better understand both performance and costs.

An example of the benefits of this combined offering can be explained in a common scenario. If a person with diabetes goes into insulin shock today, a hospital can only measure the cost and the outcome of that emergency care. But insulin shock is inherently a poor outcome that should not happen. By combining these solutions, providers should be able to spot patients who fail to file claims for prescription medicines –  all too often the cause of insulin shock – and take steps to prevent a worsened condition that leads to a more expensive hospital stay. Even if hospital care is required, claims data will help hospitals ensure that the post-discharge plans are followed effectively, and intervene if the appropriate medical care hasn’t been sought to avoid a preventable readmission.

Health system members of PACT™ (Premier’s Partnership for Care Transformation) will participate in a series of short-term performance improvement initiatives that will use the data and tools to determine the total cost and efficiencies of care for a defined population. PACT™ members will share their learnings and experiences to help the alliance further build and define the capabilities that will be required for new delivery models. Based on this initial work, Premier and Verisk Health anticipate developing new analytic offerings targeting the emerging needs of integrated delivery systems.

About the Premier healthcare alliance, Malcolm Baldrige National Quality Award recipient
Premier is a performance improvement alliance of more than 2,500 U.S. hospitals and 81,000-plus other healthcare sites using the power of collaboration to lead the transformation to high quality, cost-effective care. Owned by hospitals, health systems and other providers, Premier maintains the nation's most comprehensive repository of clinical, financial and outcomes information and operates a leading healthcare purchasing network. A world leader in helping deliver measurable improvements in care, Premier has worked with the Centers for Medicare & Medicaid Services and the United Kingdom's National Health Service North West to improve hospital performance. Headquartered in Charlotte, N.C., Premier also has an office in Washington. http://www.premierinc.com. Stay connected with Premier on Facebook, Twitter and YouTube.

About Verisk Health
Verisk Health, a subsidiary of Verisk Analytics (Nasdaq:VRSK), helps organizations identify, manage and mitigate healthcare risk to improve quality, reduce costs and maximize profitability. Our data-driven risk assessment technologies and business decision analytics enable clients to proactively seize opportunities for improving clinical, financial and performance results including care management; risk identification and stratification; HEDIS compliance; benefit program measurement; fraud, waste, and abuse prevention; payment accuracy; and revenue cycle management. For more information, please visit www.veriskhealth.com.