Herding cats…an idiomatic saying that refers to an attempt to control or organize a class of entities which are uncontrollable or chaotic, according to Wikipedia.
You can even search YouTube with the phrase “herding cats” and find some entertaining results, my favorite being 100 cats set lose in a huge department store.
One cat gets stuck behind a wall requiring a hole to be cut for its rescue; another escapes the inescapable area set up to contain the felines. I kept thinking, who came up with this idea, and why did store management ever agree to it?
So does healthcare possibly offer a similar paradigm?
- What if you had 100 physicians…or maybe a 1,000, set lose to treat patients, as each determined best.
- Can you imagine the outcomes, the variations?
- What if these docs could refer to other docs and then those docs could refer again to other docs.
This is a scenario that Atrius Health, one of 32 Center for Medicare and Medicaid Innovation (CMMI) Pioneer ACO’s, calls “Malignant Outside Utilization,”or MOU, which is when uncontrolled and rampant referrals expand outside their physician network for their covered beneficiaries.
Atrius Health is managing MOU by leveraging clinical & business intelligence (C&BI) techniques. Using the Medicare claims Medicare their beneficiaries incurred, Atrius Health is tracking the referral patterns of their physicians to those inside and outside its network, the resulting referrals from those referrals, and so on. Using this analytical technique to identify deep referral patterns, this Pioneer ACO can then take measures to address at the source where the referrals start.
This creative and intuitive approach – to understanding healthcare and clinical business using analytics and “big data” – designates Atrius Health as a true pioneer.
For more information, download the white paper from HIMSS Analytics sharing how Atrius Health strategically deploys C&BI and analytics.