Reducing Total Cost of Care & Improving Care Quality
Health, Wellness and Fitness Case Studies and Success Stories with CareJourney
CASE STUDY Transcarent
Transcarent used the CareJourney platform to give its 1.3 million members better healthcare choices. They needed strong data on provider quality and costs to help people pick the right care. CareJour...ney gave Transcarent detailed provider insights and easy data integration. This helped Transcarent offer flexible pricing, cut admin costs, and connect patients to top care centers. Transcarent also saved money by using one data partner for all their needs.
Beaumont ACO improved referral processes using CareJourney’s Provider Performance Index, enhancing specialist cost-effectiveness insights for over 325,000 covered lives, leading to better provider ...performance evaluation.
CareJourney’s MSSP Financial Benchmarking helped an ACO enablement company with a national reach. The company needed to prioritize sales conversations with over 30 primary care practices before a key... CMS deadline. CareJourney provided data to identify practices with higher MSSP attribution and projected financial benefits. The company used these insights to expand into two new states and avoid groups with low volume or negative benchmarks. This allowed them to grow their ACO footprint and prepare for success in the Medicare Shared Savings Program.
CareJourney’s Cohort Atlas helped a digital health management company segment patients with chronic conditions into detailed cohorts. The company struggled to identify which patients would benefit mo...st from specific interventions. CareJourney enabled them to analyze cost, utilization, and outcomes for each cohort. They found that comorbidities like behavioral health more than doubled expected utilization for diabetes patients. The insights allowed the company to target benefits, improve patient outcomes, and increase ROI.
UpStream used CareJourney’s BCDA analytics to track provider cost and utilization trends in real time. They needed faster analytics for ACO REACH participants to support patients and align physician ...payments. CareJourney enriched weekly claims data, helping UpStream benchmark spend, track avoidable ER visits, and forecast risk scores. UpStream created weekly expenditure reports and closed monthly financials faster. Over 1,000 PCPs benefited from more timely insights and reduced care gaps.
Management Consulting Case Studies and Success Stories with CareJourney
CASE STUDY Guidehouse
Guidehouse used CareJourney Provider and Cohort Analytics to improve insights for healthcare clients. Guidehouse needed national provider cost and quality data to support client growth and care impro...vement. CareJourney delivered provider network and performance data, which Guidehouse integrated into their data warehouse. This helped Guidehouse create dashboards and visualizations for clients. Guidehouse expanded their client base and improved performance oversight services with CareJourney's data.
Insurance Case Studies and Success Stories with CareJourney
CASE STUDY A tech-forward health plan
CareJourney Provider Intelligence helped a tech-forward health plan improve its member provider directory. The plan wanted to help Medicare Advantage members find top providers and lower care costs. ...CareJourney gave the plan cost and quality scores for providers. The plan used these scores to rank providers and build better networks. Over 100,000 members had a better search experience and gave positive feedback.
CASE STUDY An emerging regional payer centered around serving the senior population
CareJourney helped an emerging regional payer use data analytics to improve primary care provider performance. The payer wanted to grow its network and needed better data to make decisions. CareJourn...ey gave them access to eight years of claims data and provider performance metrics. The payer used CareJourney’s network simulation and provider performance index to pick top-performing practices for value-based contracts. This helped them expand their market and secure the right partnerships.
CareJourney helped a growing Health Plan with over 60,000 members expand into new markets. The Health Plan faced challenges in identifying the right physician groups and understanding provider qualit...y, cost, and connections. Using CareJourney’s analytics and Market Assessment tool, the plan found high-performing providers and improved network adequacy. As a result, the Health Plan expanded its network, advanced value-based care, and achieved high network integrity.
Hospital & Health Care Case Studies and Success Stories with CareJourney
CASE STUDY A midwest Accountable Care Organization (ACO)
CareJourney helped a midwest Accountable Care Organization (ACO) lower costs for patients with Congestive Heart Failure. The ACO used CareJourney to track spending and measure the impact of care inte...rventions. Care managers worked with over 200 patients to guide them to better resources and care. After 12 months, the ACO saw an $8,000 reduction in average total spend per patient. The analysis also helped the ACO match care coordinators to patients more effectively.
CareJourney’s Network Advantage platform helped CURA Health Management grow its provider network by 50% in one year. CURA used CareJourney analytics to find and recruit high-performing providers for ...its ACOs. The platform made it easy to identify providers not in other ACOs or payment models. CURA also improved cost and quality scores for its providers. In 2021, their Cost Index rose by 0.17 points and Outcomes Index by 0.13 points compared to 2020.
CASE STUDY Innovative Physician Enablement Company
CareJourney platform helped an innovative physician enablement company with direct contracting. The company needed accurate beneficiary alignment estimates and better provider analytics. CareJourney ...provided tools for alignment estimation, provider benchmarking, and network planning. The platform supported network expansion and improved provider performance. The company manages over 250,000 lives using CareJourney's data and analytics.
CareJourney helps Banner Health improve provider performance. Brett Bingham from Banner Health uses CareJourney as a trusted data source. He relies on CareJourney for provider performance conversatio...ns. The platform gives him important data and insights. This helps Banner Health make better decisions about their network and care. Banner Health trusts CareJourney for accurate provider analytics.
CASE STUDY Delaware Valley Accountable Care Organization (DVACO)
CareJourney helped Delaware Valley Accountable Care Organization (DVACO) analyze rehabilitation therapy for Frail/Elderly patients. DVACO wanted to lower the total cost of care for these patients. Ca...reJourney used a patient segmentation model to find the best amount of therapy. The analysis found that 13-32 therapy units led to lower costs. Patients who got outpatient therapy had $7,000 less in annual care costs than those who did not. DVACO now partners with therapy providers who follow these best practices.
CareJourney helped PraxisCare move to risk-based care models. PraxisCare used the CareJourney platform to analyze claims data and get insights on patient risk and provider performance. This helped th...em identify high-risk patients and high-performing providers. PraxisCare kept 100% of their partner groups as they moved to ACO REACH. They also recruited a major health system partner using CareJourney’s data tools.
CareJourney's Provider Performance Index helped Beaumont ACO improve specialist referrals. Beaumont ACO wanted a system to rate provider cost effectiveness and give actionable insights. CareJourney w...orked with the ACO to use the PPI and integrate cost scores into provider education and tools. The new system gave providers a clearer view of specialist cost effectiveness. This improved provider education and helped assess performance in a network of over 5,000 physicians.
CareJourney Market Intelligence helped a Midwest MSSP ACO find a $1.1M annual gap in their risk score benchmark. The ACO struggled to understand why their risk scores were lower than average. CareJou...rney used claims data to compare the ACO’s risk scores and coding practices to state and MSSP benchmarks. They found that heart failure was underreported due to low recapture rates. This led to missed care and lower financial benchmarks. With CareJourney, the ACO identified areas to improve coding and plans to use the tool for future audits.
CASE STUDY A national physician practice management and population health technology company
CareJourney helped a national physician practice management company analyze the performance of 1.7 million providers. The company needed better data to support primary care doctors in making referral... decisions. CareJourney provided access to 180 metrics on providers, helping the company find top specialists and improve care quality. The company used this data to build a high-performing specialist network and plans to integrate it into their EHR system. This empowered physicians to make better decisions at the point of care.
CareJourney helped Quality Independent Physicians (QIP) improve patient care and grow their provider network. QIP used CareJourney’s Network Advantage and Population Insights platforms to get a full ...view of provider performance. This made it easier to find and recruit top providers. QIP’s provider network grew by 47% between 2019 and 2021. QIP also added 2,000 new patients in 2021. The solution helped QIP deliver higher quality care at lower cost.
