This is an example from the Joint Operating Committee meeting with Cigna of a focused approach towards improving our utilization: Each of our payer contracts evaluates TXCIN for as many as 100 detailed performance metrics.

Strategic focus

  • How big is the problem?
  • How much can our efforts impact savings?

Scenario: What is the Savings Impact of:

  • 10% Reduction in Cost
  • 10% Reduction in Utilization

 

This is another example from the Joint Operating Committee meeting with UnitedHealthcare using sensitivity analysis to identify problem areas where efforts will make biggest improvement in performance:

Clinical CollaborationThis is another example from the Joint Operating Committee meeting with UnitedHealthcare using sensitivity analysis to identify problem areas where efforts will make biggest improvement in performance:

Presented Opportunities – Goal Setting

Other areas of focus for TXCIN payer contract performance are:

  • Total Medical Cost Is Trending Up Relative to the DFW Market
  • ER Utilization and PMPM Cost
  • Out-of-Network Costs when In-Network is Available

With in-depth analysis of performance outliers, we can make the most impactful use of physician time and TXCIN resources to improve performance.

If you would like more info on this, please contact your Physician Strategist Specialist