Provider Cost and Quality Index – PQI
Session Abstract: Virtual Only
Because a greater proportion of our healthcare expense is coming out-of-pocket, healthcare reform challenges consumers to become more actively engaged in their care. High deductible plans mean more self-pay until deductibles are met. Most consumers have no way to evaluate the cost or quality of the options available to them, nor any negotiating leverage. Employers large enough to self-insure bear risk for their employee populations while lacking objective data to make decisions. Large payers, including CMS pay largely on a volume-based, fee-for-service model. PQI can guide CMS on a fair way to divide bundled payments made to an ACO.
Healthcare reform measures envision a delivery system based on value, that weaves wellness, prevention, and population health into a complete package—all steps taken to avoid acute interventions delivered in the most efficient care settings. With the informed patient at the center, the most efficient, cost-effective providers will be rewarded. Ultimately, the patient wins.
The missing element required to move the industry from a volume-based, fee-for-service model to a value-based system is the Provider Price & Quality Index (PQI or Index). The Index is a collection of standard cost and quality metrics for every classification of provider. The metrics that are used to calculate the index include:
• Patient Satisfaction
• Employee Satisfaction
• Today’s Cash Price, paid at the point of care for your top 50 procedures
• Quality Measures – top 2-3 based on care setting and provider type, reported to state and Federal authorities
• Medication Adherence – a measure of effectiveness
• Benchmark – Rank Among Peers, minimum of 5 in a cohort
• Incremental Improvements in Index Value – your ability to move the needle from month to month
Once calculated, refreshed monthly and posted, any healthcare consumer can compare providers in their market and make educated decisions about their care. The Index enables market forces to impact the delivery of care by providing objective data to consumers in a way that they can understand.
No group of legislators or “suits” is going to define quality for Orthopedic surgeons, radiologists, cardio-thoracic surgeons, neurosurgeons, or any other medical specialty without serious push-back. The various physician membership organizations poll their members to gain agreement on the top few quality measures for their sub-specialty—measures that matter most to patients today. Further, they will be given the freedom to modify these measures on an annual basis to keep it relevant to their patients’ needs.
Area Director at Virtual Radiologic
In a 25-year career in healthcare IT infrastructure, software and specialty physician services to hospitals and health systems, Bill brings energy and innovation to the challenges faced by healthcare administrators.
Areas of expertise include identification of early adopters for emerging technology companies, start-ups seeking pre-IPO growth, and mature companies that seek new business models. Start-up companies that Bill has been a part of have seen successful mergers, acquisitions, IPOs.
The Provider Cost & Quality Index (PQI), conceived and designed by Bill Schneider is a patent-pending, cloud-based system that leverages Big Data in a real-time collection of metrics and algorithms to inform healthcare consumers, providers, and payers of the relative value of healthcare services. It is processed monthly and delivered to the market for real-time health decisions by consumers, payers, providers and governments.
PQI is the vehicle to move the industry from a volume-based model of care to a true value-based care model for prevention, population health, and personal accountability initiatives to be measured and rewarded.
End-User, Government, Enterprise, Small / Medium Enterprise
Cloud-based platform to objectively compare healthcare providers in real time. It is Big Data finally being applied to healthcare in a way that is digestible for the common consumer of healthcare services
CxO, VP / Director, Middle Management
Expert, Advanced, Intermediate
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