Medicare data sets provided by CareSet will enhance CURA’s ability to service a targeted population
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JACKSONVILLE, Fla. – Healthcare enablement company and operator of several Medicare Shared Savings Program contracts, CURA Health Management announced today a strategic partnership with CareSet Systems, a nationally recognized provider of Medicare data sets and analytics. With this partnership, CURA will be better equipped to address the emerging needs of organizations that serve a growing Medicare population, specifically Medicare Accountable Care Organizations.
10,000 beneficiaries age into Medicare every day, expanding the annual federal budget for Medicare by nearly $90 million every day. While unsustainable from a taxpayer and budgeting perspective, providers are also seeing a reduction in revenue as their patients move from commercial fee schedules to Medicare. This revenue impactrisk-adjustedn annual margin reduction of more than $12 million every day. Providers see this as unsustainable and recognize best of a few paths forward is to capture both market share and participate in risk programs driving the systemic improvements in care delivery.
CareSet has been able to capitalize on access to the national Medicare Fee for Service data set, and presents the information in an unprecedented fashion that directly addresses the needs of the Medicare ACO community. Using the largest single cohort of patients available, CareSet, provides a four-dimensional view of the Medicare claims which identifies near and long-term opportunities for the provider, payer and ACO communities. In a combined effort, CURA and CareSet have paneled every Medicare beneficiary to a PCP and calculated the PCPs risk adjusted panel cost, as well as scored other important performance measures. Knowing the PCPs absolute, peer relative and geographic relative performance is critical in the face of regional benchmarking and risk requirements in the Medicare Shared Savings Programs.
“This capability is incredibly important to the Medicare ACOs when comparing individual PCP performance to the regional benchmark of the PCP’s patient base,” points out Mike Barrett, Founding Partner of CURA Health Solutions. “There are now roughly 80 Medicare ACOs facing downside risk and regional benchmarking for the first time, and CURA has the ability to calculate opportunities and risks for each track, as well as provide support to manage their network and MSSP strategies for an optimal result.”
The data sets from CareSet allow CURA to identify an organizations’ specific opportunities and challenges and provide unique insight into how they compare with their local peer groups and negotiate more beneficial partnerships with payers and managed care companies. CareSet’s concrete analytics enhance CURA’s mission to allow local market provider entrepreneurs to own and operate their own Value Service Organization in a franchise mode and deliver best in class healthcare to their patients.
“Both data and insights are critical to help ACOs thrive in this new healthcare paradigm,” says Laura Shapland, CEO, CareSet Systems. “CareSet’s Medicare data combined with CURA’s insights offer great promise to improve patient care at healthcare organizations nationwide.”
About CURA Health Management
CURA is a healthcare enablement company that empowers local market provider entrepreneurs to own and operate their own Value Service Organizations in a franchise model that extends their reach and capabilities to maximize revenue, deliver quality care and improve patient outcomes. CURA’s innovative resources and expert solutions are administered as an extension of providers’ current in-practice resources, expanding care coordination and care management services. These solutions support financial success within both traditional payment models and expansion to new services, allowing partners to succeed within current and ever emerging value based payment models. To learn more please visit our website, follow us on Facebook or connect with us on LinkedIn.
About CareSet Systems
CareSet Systems is the nation’s first company with access to 100% Medicare Part A, B and D claims and enables the nation’s leading pharmaceutical companies to decode Medicare claims data to guide new drug launches. Learn more at https://careset.com.