Valence Health, a data analytics and management solutions vendor, helps its 10,000 independent physicians use economies of scale that come with clinical integration – even when they lack a common health care information platform.
SAS, the leader in business analytics software and services, provides Valence the business intelligence – patient-centred, data-focused support – to help doctors and hospitals manage risk, strengthen finances and improve patient care.
Using SAS Business Analytics and SAS Web Report Studio, Valence created a tool that accesses a medical community's billing system and automatically pushes data to Valence on a scheduled basis.
Valence uses SAS to scrub the data, apply appropriate clinical care guidelines and then pass information back to physicians.
"The ROI for doctors is enormous," say Todd Stockard, senior VP of financial and data management services at Valence Health.
"By being clinically integrated through our approach, physicians have been able to increase compensation (fees and P4P) from health plans by 15 to 20%. Before, individual doctors had no leverage in negotiations. In one region, doctors were getting 110% of Medicare prior to clinical integration.
"Once they cleared regulatory hurdles and negotiated together, they received 130% of Medicare. Clinical integration distributes financial risk and allows doctors to compete for more market share, which also provides patients with better access to informed care."
Physicians using the Valence tools also can mine data to track patients across providers and assure, for example, that childhood immunisations are up to date.
"We've turned our service from a retrospective view of where mistakes might have occurred to a proactive alert system that helps keep the population healthy – all with SAS," says Stockard.
"When we started, our vision was that health care providers needed to take control of their destinies. US health care reform is saying the same thing 15 years later. The concept of accountable care organisations (ACO) and pushing more accountability back to the providers is what our business model is all about."