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RowdMap Risk-Readiness Financial Use Cases


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RowdMap’s Risk-Readiness® Benchmarks help health plans, physician groups, and hospital systems identify, quantify, and reduce no-value care that physicians deliver—a central tenet of successful pay-for-value programs.

Case Studies include: Optimizing Existing Network for New Market Segment Expansion; Targeted Sales and Marketing with Highest Performing Practices; Modeling Narrow Specialty Network Savings.

An Ernst and Young EY Entrepreneur Of The Year®, RowdMap helps providers and payers identify, quantify and reduce low-value care in 46 states covering over 91 million patients and members and is a partner of US News and World Reports.

Published in: Health & Medicine
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RowdMap Risk-Readiness Financial Use Cases

  1. 1. All contents are proprietary to RowdMap, Inc. and are being provided on a confidential basis. Any use, reproduction or distribution of this information, in whole or in part, or the disclosure of any ofits contents without the prior written consent of the Company, is prohibited. Unwarranted Variation RowdMap's Risk-Readiness® Platf orm helps identify “unw arranted variation” in t he practice of medicine. This term was defined decades ago by medical researchers at Dartmouth to describe the collective practice pattern fingerprints of physicians around the country. Some physicians prefer to start with less intensive treatment options, while others may send patients straight to surgery. In ot her cases, treatments vary by geography. Understanding this variation is a significant key to success in pay-for-value programs. Identifying and Managing Variation Is a New Opportunity “It’s generally agreed that about 30 percent of what we spend on health care isunnecessary. If we eliminate the unneeded care, there are more than enough resources in our system to cover everybody.” - Dr. Elliott Fisher, Dartmouth Institute for Health Policy “Unwarranted variation cannot be explained on the basis of illness or the preferences ofpatients. Such variations result from influences that the supplyside exercises on the patterns of practice.” - John E. Wennberg, Founding editor of The Dartmouth Atlas of Health Care UnwarrantedVariation,FinancialOpportunity RowdMap’s Risk-Readiness® benchmarks help health plans and physician groups to increase the number of patient interactions with more efficient providers that are better at managing unwarranted variation. This shift can be achieved through network, product, or sales and marketing efforts and significantly reduces the delivery of no-value care. Case Study: Optimizing Existing Network for New Market Segment Expansion Tasked with building a new network for a market segment expansion, a health plan’s network team decided t o use Row dMap’ s physician benchmarks to add higher performing physicians and remove lower performing physicians from an existing baseline network instead of starting from scratch. This approach resulted in substantial medical economic savings that could then be used to enrich benefits.
  2. 2. RowdMap, Inc. 710 West Main Street Louisville, Kentucky 40202 1-855-RowdMap © 2015 RowdMap, Inc. Trade Marks and Trade Secrets also apply. About RowdMap RowdMap’s Risk-Readiness® benchmarks help health plans, physician groups, and hospital systems identify, quantify, and reduce no-value care t hat physicians deliver—a central tenet of successful pay- for-value programs. Through practice pattern and referral analysis, RowdMap’s benc hmarks identify the health care entities that manage unwarranted and unexpected variation in care. This variation leads to more than $850 billion in no-value care annually. Payers and physicians use RowdMap’s physician and population health benchmarks to create strategies that put these highest performing physicians at the cent er of networks and t hen design products, organize clinical programs, and coordinate sales and marketing around them. Row dMap's Risk-Readiness® platform comes preloaded with benchmarks for every physician, hospital, and zip code in the United States— no IT integration required. R owdMap’s com bination of platform data and the analytic product suit e works across all market segments and has significantly larger returns than traditional medical economics approaches. . Case Study: Modeling Narrow Specialty Network Savings After board mandate for profitability for a specific market segment, a plan used Row dMap’s physician benc hmarks as a core input to a strategy to narrow specialty networks. Row dMap identified specialist s to remove and add as well as modeled the financial impacts to that plan’s future profitability. Case Study: Targeted Sales and Marketing with Highest Performing Practices Looking to increase ROI from sales and marketing efforts, a health plan used Row dMap’s benchmarks to identify and target sales and marketing efforts around during an annual enrollm ent period. These efforts resulted in significant savings as membership grew int o practices with more efficient physicians.