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Applying Analytics for
Value-Based Success:
An ACO Case Study
© 2015 The Carolinas Center for Medical Excellence
Today’s Presenters
Angela Diaz, MBA, PT
Stephen Nuckolls, MAC
Director of Provider Services
CCME
Chief Executive Officer
Coastal Carolina Quality Care
Your Partner in Quality Health Care
For over 30 years, we have served health care providers,
networks, and payers – in both public and private sectors –
to facilitate better health outcomes at lower costs, through:
• Quality improvement
• Review and cost reduction
• Data analytics
• Consulting and education
About CCQC
• Physician-owned and -operated ACO
• Multi-specialty
• Serving eastern North Carolina
• CCQC’s aggregate quality results: #2 out of 220
among ACOs in 2012 and 2013
• CCQC reduced inpatient admissions by >20%
ConvergX is an advanced data analytics
solution that translates large volumes of
claims data into actionable insights that can
be used to improve care and reduce costs.
Today’s Goals
• Spotlighting the metrics that matter most to population
health management
– Claims utilization
– Attributed provider assignments
– Risk-adjusted cost
– Hospital readmissions
– Emergency department utilization
• Patient-, provider-, facility-level data
• Benchmarking
Let’s Discover the Insights
Hidden in the Data …
Today’s Goals Revisited
• Spotlighting the metrics that matter most to population
health management
– Claims utilization
– Attributed provider assignments
– Risk-adjusted cost
– Hospital readmissions
– Emergency department utilization
• Real-life applications
Questions and Answers
ConvergX Can Help You:
• Improve care
coordination
• Reduce unnecessary
utilization and cost
• Identify outliers
• Improve health
outcomes
How About Your ACO?
HIPAA-compliant demonstration
using your data available
For more information:
Angela Diaz, MBA, PT
[email protected]
919.461.5670