Richard Cramer, Informatica’s Chief Healthcare Strategist and Maury DePalo, Director of Edgewater’s Healthcare Practice, will discuss the challenges of identifying, integrating, delivering, and governing the diverse sources of performance data necessary to enable and measure the shared risks and rewards of accountable care delivery models.

1. Let’s Talk Healthcare with Informatica and
Edgewater: A Foundation for Achieving
Value-Based Healthcare
Richard Cramer Maury DePalo Michelle Blackmer
Chief Healthcare Strategist Director, Healthcare Practice Director, Healthcare Product Marketing
Informatica Edgewater Informatica
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2. Transitioning from Current Operating Models --
An Iterative Approach for Incremental Implementation
Assess the Envision the
Current State Future State
Process Data
Needs Needs
Analytic
Capabilities
Increasing Capabilities on Each Cycle through the Process
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3. Use Case 1 - Reporting & Analytics
Integrating Clinical & Financial Performance & Risk Management
Specialty Care: Dr. Rubenstein
By Practice Area, By Physician
Primary Care: Dr. Jamieson
By Service Types
PMPM / Utilization / Adherence to Std / Clinical Risk /
Inpatient
Financial Risk DOS Procedure Submit Amt Paid Amt
Outpatient Claim Nbr: 2006-1001-00101
3/30/2006 CPT 77057
3/30/2006 CPT 88174
Claim Total
Screening Mammography, Bilateral ...
Cytopathology (Liquid-Based)
$
$
$
105.00
45.00
150.00
$
$
$
95.00
55.00
150.00
Claim Nbr: 2007-1310-00322
5/19/2007 CPT 77057 Screening Mammography, Bilateral ... $ 105.00 $ 95.00
5/19/2007 CPT 88174 Cytopathology (Liquid-Based) $ 45.00 $ 55.00
Claim Total $ 150.00 $ 150.00
Claim Nbr: 2009-1561-00451
7/30/2009 CPT 77057 Screening Mammography, Bilateral ... $ 105.00 $ 95.00
7/30/2009 CPT 88174 Cytopathology (Liquid-Based) $ 45.00 $ 45.00
Claim Total $ 150.00 $ 140.00
Claim Nbr: 2010-1833-00729
12/10/2010 CPT 88174 Cytopathology (Liquid-Based) $ 45.00 $ 45.00
12/19/2010 CPT 77057 Screening Mammography, Bilateral ... $ 105.00 $ 95.00
Professional Fees
Claim Total $ 150.00 $ 140.00
Normative Data
Provider
Radiology
Specification
Patient
Specification
Provider
Peer Group
Service
Laboratory
Specification ?
Provider A Result A
Location
Specification
Provider B Result B
Other
Specification
Provider C Result C
Provider D Result D
 Year over Year, Quarterly Performance & Tracking

By Time Frame
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4. Use Case 2 – Patient & Physician Attribution
Collaborative, Patient-Centered Care
Primary
Hospital Care
Groups
Specialty
SNF, LTC
Groups
Physical
Rehab
Therapy
Payers
Shared Accountability – Shared Risks & Rewards – Coordinated Delivery Platform
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5. Use Case 2 – Patient & Physician Attribution
• Establishing a Performance Track Record
• Baseline of Effective, Efficient Patient Care & Favorable Outcomes
• Which Patients, Which Services, What Outcomes, What Costs?
• Quality  Efficiency  Value
• Evidence-based Rationale for Components of Shared Value Proposition
• Value Added at Each Step in Coordinated Process of Encounters to Outcomes
• Primary Building Blocks
• Models: Data, Process, Business, Populations & Practices
• Technology: Data Capture, Quality Control, Integration, Transformation,
Aggregation, Analytics
• Defining Accountability
• Who is accountable, and for what?
• Shared accountability – measure team and individual performance against
industry or institutional standard (structures, processes, metrics)
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6. Learn More…….
• Register for the second webinar in the series:
A Foundation for Achieving Value-Based Healthcare
Wednesday, November 14, 2012
11:00am PT / 2:00pm ET
http://vip.informatica.com/?elqPURLPage=10576
• Click here to view our first webinar, Journey to
the Future of Healthcare Delivery
• To join future webinars in the series,
click here
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