Physician Group Module

What: Being able to search and analyze quality and cost metrics at the physician group level. EXAMPLE: Meaning having a physician group search module in Explore (alongside Physicians, Hospitals, HH, HOS, SNF) and then to have a physician group Analyze page.

Why: Almost all ACOs tracks must add all physicians within a physician group NPI (TaxID). They are not allowed to add one physician that's part of a group. Therefore they need to know how the group performs as a whole. When targeting physician groups to add to their ACO, they need to be able to search and look at the detailed performance for physician groups - with things like how well are they managing costs, are they keeping patients out of the ER/Hospital (unplanned hospital visits), are they doing preventative medicine today, what are their top DX as a practice and are they unspecified codes, what are their referral patterns and what are they sending patients out for (ex: EKG), etc. An added bonus for us is this will help with the <11 counts. They need to be able to see what physicians make up that group with the ability to analyze an individual physician.

Who: All ACO and Health Plans would need this. Direct Contracting Entities would like this but please know they are allowed to add individual docs BUT they are mostly still adding physician groups.

When: No definite deadline that this is needed but it is a very high priority item if we want to focus on ACOs. I think this is a must have (or only a month or two later) for an ACO release.

Prospects and customers that mentioned this: Vytalize, Scripps Health, Bright Health, VillageMD that I can think of right now

Revenue Tied to This: Wellcare $140K

Industry Must Have: ACO, Direct Contracting, Health Plans

Competitors that already have this: CareJourney