USE CASE: Understanding How Provider Practice Patterns Impact Unnecessary Tests and Treatments

 MediQuire works with health care stakeholders to accelerate the move towards value-based care. They help payers design and negotiate contracts that maximize ROI and track signed value-based contracts using claims and EHR data in real time. They also help providers by enabling them to understand their existing performance to negotiate achievable contract terms and uncovering actionable insights that allows providers to take the necessary steps in order to succeed in value-based contracts.

 Project Summary: CO APCD data is helping MediQuire understand how provider practice patterns contribute to the utilization of higher cost place-of-service and unnecessary tests and treatments. It also allows MediQuire to quantify the magnitude of potential cost savings when a patient is given the appropriate care and/or is steered to the most cost effective provider.

 Benefit to Colorado: Unnecessary tests and treatments are major cost drivers in the health care system. Findings from this project could inform specific recommendations surrounding optimal practice behavior that may maintain or improve patient health while lowering costs.