Value

Identify sources of low-value health care, why it happens, and how to reduce it

Low-value health care includes any services that are unnecessarily costly or not beneficial to patient health. Some examples are the overuse of unneeded services, under-use of needed care, services used to treat potentially avoidable complications (PACs), and services with large price differences based on where they are performed. This is the only tool that provides a comprehensive view and in-depth analysis of low-value care, so you know why it’s happening and where to focus your reduction efforts.

Product Features

Provides detailed aggregate and per-episode reports on types, amounts, and key drivers of low-value care
Quantifies individual provider contribution to ineffective and inefficient care
Creates a dashboard to track low-value care against benchmark comparisons, and hold providers and payers accountable
Identifies “low-hanging fruit” to show your best opportunities for reducing low-value care.
Helps ensure the delivery of needed services – while decreasing the level of unneeded care currently being delivered and paid for

Health Systems

Identify provider contributions to low-value care. Track low-value care against benchmarks. Help ensure delivery of needed care.

Medicaid

Identify provider contributions to low-value care. Track low-value care against benchmarks. Help ensure delivery of needed care.

Health Plans

Identify provider contributions to low-value care. Track low-value care against benchmarks. Help ensure delivery of needed care.

Employers

Identify provider contributions to low-value care. Track low-value care against benchmarks. Help ensure delivery of needed care.

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Neonatal Intensive Care Units (NICU) are typically reserved for infants with serious issues that require highly specialized care. However, analyses of Medicaid claims using PROMETHEUS Analytics found that NICU designation varies widely among facilities. These variations in rates of use, costs, and lengths of stay can seriously impede a facility’s ability to achieve savings under value-based bundled payments. By better understanding this variation and its sources, facilities can take steps to standardize assignment of newborns to NICU and, by extension, reduce costs of postpartum care.

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Guidelines from the American College and Congress of Obstetricians and Gynecologists recommend vaginal hysterectomy (VH) as the preferred treatment for benign gynecological disease. However, analyses using PROMETHEUS Analytics found that rates of alternative procedures, which have higher prices and greater risk of severe complications, consistently exceed that of VH, sometimes by 50% or more. This insight opens a significant opportunity to reduce costs and patient harm by switching to the more clinically recommended treatment.

Identify sources of low-value health care, why it happens, and how to reduce it

Product Features

Health Systems

Medicaid

Health Plans

Employers

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Promoting a More Effective, Less Costly Procedure.png

Episode Analytics to Guide Your Value-Based Care Transition