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Thursday, 19 February 2015, 06:00 HKT/SGT
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Source: marcus evans Summits
How to Eliminate Procedure Preapproval to Save Billions in US Health Spending
Mike Doyle of QPID Health, Inc., a solution provider at the marcus evans National Healthcare CMO/CMIO Summit 2015, talks about lowering healthcare costs by ensuring appropriate use.

NEW YORK, N.Y., Feb 19, 2015 - (ACN Newswire) - "Appropriate use of diagnostics and procedures is a strategic imperative for providers focused on improving population health while lowering costs," says Mike Doyle, President & Chief Executive Officer, QPID Health, Inc. "With as much as a third of US healthcare spending wasteful or unnecessary, payers respond by requiring medical necessity reviews, especially for high-cost and high-volume procedures," he adds.

A solution provider at the marcus evans National Healthcare CMO/CMIO Summit 2015, in Atlanta, Georgia, March 9-10, Doyle discusses how QPID Health's customer Partners HealthCare achieves the highest possible rates of appropriate use and aligns with payers to waive prior authorization.

- Why did Partners HealthCare initiate the Q-Guide program?

Partners HealthCare is a pioneer accountable care organization (ACO) that also operates under shared-risk contracts with private payers. Committed to 100 percent appropriate care because it is the right thing for patients, Partners also was motivated to make sure that surgeons and other clinicians were applying evidence-based care standards to keep costs in check.

- What are some of the benefits of the program?

Elimination of preapproval requirements in the US could increase billing efficiency by 50 percent and save hospitals USD 17 billion and physicians USD 6.9 billion, while ensuring better outcomes. Now ACOs and other providers who share risks with payers have additional incentives to be vigilant about costs.

- What is Q-Guide?

Q-Guide is an application that delivers guidelines from the literature and synthesizes them with patient factors automatically gleaned from the medical record. It applies sophisticated decision criteria to patient medical profiles to produce an optimal procedure recommendation.

Hospitals can forego the prior authorization process for some procedures where physicians have attested the appropriate use with Q-Guide. This eliminates a huge administrative burden for providers and reduces the pain and uncertainty for patients who traditionally must wait while medical necessity reviews are underway. And most importantly, healthcare decisions remain in the hands of medical providers and their patients.

Q-Guide currently covers 15 procedures, seven of which account for 55 percent of the 20 most costly surgical procedures in the US.

The technology frees up time spent mining electronic health records and data repositories, while dramatically shifting the patient/doctor conversation toward shared decision-making.

- Any final comments?

Two major payers have agreed with this approach so far, and waived requirements for manual prior authorization Q-Guide. The incorporation of patient-reported outcomes into the decision model is the latest development effort to improve care, engage patients, and track long-term outcomes.

To view a webinar by Partners Healthcare sharing their experience with Q-Guide, click here

About the National Healthcare CMO/CMIO Summit 2015

The National Healthcare CMO/CMIO Summit is the premium forum bringing senior level medical executives and solution providers together. Taking place at The Ritz-Carlton Buckhead, Atlanta, Georgia, March 9-10, 2015, the Summit includes presentations on succeeding under value based purchasing, implementing Meaningful Use Stage 2 into the healthcare organization, EHR implementation and discussion on merging clinical data and insurance data to improve quality and outcomes.

For more information please send an email to press@marcusevanscy.com or visit the event website at www.nhcmiosummit.com/MikeDoyleInterview3

marcus evans group - healthcare sector portal -
www.marcusevans.com/reviews/healthcare

The Healthcare Network - marcus evans Summits group delivers peer-to-peer information on strategic matters, professional trends and breakthrough innovations.

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Please note that the Summit is a closed business event and the number of participants strictly limited.

About QPID Health, Inc.

QPID Health's clinical intelligence software automatically delivers relevant patient information from electronic health records and other data sources into clinical and administrative workflows. With QPID, clinicians are more productive, patients benefit from decisions based on their complete health information, and hospitals gain cost efficiencies. The QPID solution was developed at Massachusetts General Hospital and usage spread virally throughout the Partners HealthCare system. QPID Health launched in late 2012 to bring the power of QPID to health systems nationwide. www.qpidhealth.com.

Contact:
Sarin Kouyoumdjian-Gurunlian
Press Manager, marcus evans, Summits Division
Tel: +357 22 849 313
Email: press@marcusevanscy.com


Topic: Press release summary
Source: marcus evans Summits

Sectors: Daily Finance, Daily News
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