SAN MATEO, Calif.--(BUSINESS WIRE)--With value based payment, health plans and clinically integrated networks (CINs) need to provide access to the best possible healthcare in a timely manner at the lowest total cost. “One important way to meet this goal is to steer patients to those network specialists that efficiently provide a specific procedure and have time availability,” stated Dr. Douglas G. Cave, President of Cave Consulting Group (CCGroup). Issues today are health plan and CIN leaders: do not know the efficient specialists and sub-specialists; do not know those specialists that perform specific procedures or how often; and recognize patients wait too long to receive a needed procedure (often two months or longer).
Until recently, this access to care and efficiency information was not widely available; but this changed in 2021. Dr. Cave confirmed, “At a medical condition and procedure level, CCGroup is the first company to produce access to care, efficiency and effectiveness information on over 80% of practicing physicians in the United States.”
This access to care, efficiency and effectiveness information comes through the CCGroup-CMS Innovator Project. Dr. Cave defined, “The CCGroup-CMS Innovator Project allows CCGroup access to more than 60 million Medicare beneficiaries’ claims data over multiple years. With this claims data, as well as other datasets, CCGroup has one of the largest, complete claims databases in the country.”
“Moreover, our clients depend on CCGroup to produce the most accurate and reliable physician access to care, efficiency, and effectiveness information for their patient steerage programs,” stated Yuri Alexandrian, Chief Operating Officer of CCGroup. “Successful patient steerage requires CCGroup’s proven accurate, transparent, and market accepted efficiency and effectiveness advanced analytics.”
Clients retrieve the physician access to care, efficiency and effectiveness information for patient steerage and other value based programs through the CCGroup Cloud/SaaS subscription model.
About Cave Consulting Group, Inc. (CCGroup)
Cave Consulting Group, Inc. is a software and consulting firm located in San Mateo, California. The company is focused on improving the efficiency (cost-of-care) and effectiveness (quality-of-care) of the healthcare delivery system. Senior management of CCGroup has assessed the performance of physicians and hospitals for over 30 years for health plans, health systems, HMOs, physician groups, CINs, ACOs, TPAs, and employers.
