IT Spending Guide: Place Your Bets
But a proof of concept with BaseHealth over the past 18 months compared who the BaseHealth algorithms predicted would get sick with the names of those patients who actually got sick, and based upon those promising results, Banner entered into contract with BaseHealth in May 2017.
"What we're looking for out of those 50,000 individuals is who is going to be your next 5% of high-cost utilizers that are going to use 50% or more of our insurance spend," Parris says. That list consists of between 2,000 and 3,000 individuals.
"From that you actually whittle that down to a smaller group of individuals you can intervene on, so we're working with somewhere around 800 to 1,000 individuals at this time from that 50,000.
"If I just targeted the top 5%, even the predicted top 5%, I may not be giving them the right intervention or the right resources, and it will also waste resources because I will be targeting individuals that won't benefit from any intervention," he says.
Without the BaseHealth technology, Banner would never be able to build care programs around specific interventions, notes Parris. "It just is throwing spaghetti at the wall when you don't know exactly what you're targeting," he says.
Because of an MA risk-sharing arrangement with Blue Cross Blue Shield, Banner also stands to share in any money saved as a result of these interventions, Parris adds.
In addition, the BaseHealth technology is helping Banner predict its future PMPM costs for a population. "We've used it to help us negotiate on contracts already," Parris says.
To better serve its nearly 1,000 patients, nonprofit Massachusetts-based healthcare organization Element Care extended its services in participants' homes through the use of avatar technology developed by California-based care.coach.
Element Care, which operates eight sites on the North Shore of Boston and in the Massachusetts portion of Merrimack Valley and employs around 300 staff, has a mission to help people live safely and comfortably in their homes and their communities for as long as they can, keeping their stays minimal in hospitals and nursing facilities.