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Discern, LLC 1501 Sulgrave Avenue, Suite 302 Baltimore, Maryland 21209 (410) 542-4470 phone (410) 542-9990 fax
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DISCERN DEVELOPS COPD PAY-FOR-PERFORMANCE PROGRAM Discern, a health care policy consulting company, recently unveiled a new pay-for-performance program designed to improve patient care and outcomes associated with Chronic Obstructive Pulmonary Disease (COPD). The disease is among the leading causes of death in the United Sates, with 12.1 million Americans estimated to have COPD in 2006. COPD also comes with a high price - total costs nationwide reached $42.6 billion in 2007. Studies show that there are significant gaps in COPD care which greatly impact outcomes and costs. In response, Discern designed the COPD Pay-for-Performance (P4P) Program as a solution to effectively improve quality of care and manage these inefficiencies. This multi-disciplinary project demonstrates Discern's unique ability to bring together the necessary technical skills, analysis, project management, and relationships to successfully design and implement value-based purchasing initiatives. Similar to other Discern projects, the goal of the COPD P4P program is to improve quality and outcomes for patients through the appropriate use of financial incentives. Discern coordinated the COPD P4P project from idea development to purchaser engagement. Specific project tasks included strategic planning, a program blueprint, clinical research, measure specification development, financial analysis and modeling, a marketing plan, and an implementation toolkit. The Discern team first conducted research on COPD care and existing quality measures that became the technical building blocks of the P4P program. The research was analyzed and translated into a set of P4P measures and a corresponding rewards structure. Throughout this process, Discern tapped into its extensive network of industry leaders to gather valuable information and feedback. Working with Bridges to Excellence (another Discern client), Discern assembled a physician panel of pulmonologists to provide input, share best practices, and determine the most appropriate measures to reward physician performance. Discern also worked with PROMETHEUS Payment™ (another Discern client) to determine the savings that could result from improved COPD care. When the design of the COPD P4P program was complete, Discern worked with BTE to secure the organization’s endorsement and integrate the COPD measure set into BTE’s existing pay-for-performance framework and rewards structure. BTE subsequently adopted the program, which is now called COPD Care Link, and is currently exploring pilot sites around the country for implementation. Discern continues to offer technical support and help with implementation for the COPD P4P program. The COPD P4P Program is freely available for implementation by health plans and employers. The program includes:
· Step-by-step instructions for launching the program effectively · Educational materials for communication with various stakeholders: Physicians, Health Plans, Employers and Patients · A set of quality measures for COPD care · Recommendations for provider incentives
Discern has published a white paper entitled "COPD Pay-for-Performance White Paper and Technical Specifications" to explain the technical building blocks of this program, which is available to health plans and employers at no cost. Please contact Guy D’Andrea at gdandrea@discernconsulting.com or 410-542-4470 to learn more about COPD P4P program opportunities or to become a pilot market site. (For more information about Bridges to Excellence's COPD Care Link, click here).
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