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Blog & News

The Benefits to Brokers, Self-Funded Employers of Leveraging Healthcare Quality Transparency

To keep health plan costs in check, it is imperative that benefits managers at self-funded companies have access to updated, accurate information about the specific costs and quality of medical procedures, equipment and treatment, among other healthcare transparency data points. As the Network for Regional Health Improvement (NHRI) defines it, healthcare transparency is “an initiative to provide meaningful cost and quality information to patients, providers and purchasers to enable value-based healthcare decision-making.” Such informed decision-making can significantly improve group benefits outcomes if members have access to quality vs cost information before deciding where to go for healthcare services. Health plan members who view their options as a healthcare marketplace are more likely to weigh their provider, Rx, and cost options with an investors’ mentality. This bodes well for health plan outcomes because members are not only invested in their health, but also in who provides them their health services and at what cost.  

As transparency pioneer and MPIRICA Health founder and CEO Shakil Haroon discovered, it is difficult to find “easy-to-understand, trustworthy and quality information…at the procedure level.” That’s why his company developed the MPIRICA Quality Score, which has had a profound impact on transparency in today’s healthcare marketplace.

The MPIRICA Quality Score allows you, your family, and your physician to easily compare facilities and surgeons at the procedure level with a simple, three-digit number. The core of the score is a set of clinically driven, scientifically valid and weighted calculations about things that matter to patients who are having surgery.

Individuals need easy-to-use, jargon-free tools that can assist them in making more informed decisions when seeking care. This is also important to and informs health benefits design.

Quality metrics like MPIRICA’s not only allow you to compare surgeons and facilities at the procedural level, but provide an overall risk score. This, in turn, galvanizes facilities and physicians to do a better job and achieve better outcomes – and scores.

When the success and shortcomings of these healthcare providers and facilities is made public, it helps to foster an arena for constant competitive improvement in the marketplace. Providers and facilities are made more accountable and healthcare consumers get the proverbial “bigger bang for their buck”.

Additionally, employers and group benefits advisors need to know where they can get the best value from major healthcare services. Transparency is critical as the industry continues to move towards a consumer-directed healthcare model.

For this reason, Advanced Plan for Health CEO, Neil Godbey, has teamed up with MPIRICA to provide clients access to MPIRICA’s trusted measurement of surgery quality. The partnership will help APH’s broker and self-funded employer customers to make informed population health management decisions that reduce costs and optimize a group’s overall health and health plan.

As Godbey puts it, “”MPIRICA has a unique and innovative approach to objective quality transparency, and their risk-adjusted methodology makes them really stand out in the market.” Together MPIRICA and APH will partner to provide “an outcomes-based methodology derived from decades of applied medical quality data analysis experience.”

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