Its no secret that billions of dollars are spent each year on care management programs. Healthcare leaders concede that these initiatives add value.
PROFormance™ is among the industry's first stand-alone, commercially available ROI analysis and reporting application, enabling health plans and care management program suppliers to perform consistent reporting of financial, operational and clinical metrics. The application has the unique functionality to identify the Gaps in Care for user-defined clinical conditions. The flexible application uses a dynamic and continuously
PROFormance is designed to support suppliers of care management programs including employers, health plan payers and care management companies.
updated data warehouse, giving end-users access to a variety of methodologies and comparison groups, including the most-frequently encountered DMAA guidelines.
PROFormance is designed to address:
- Increasing demand for care management program results
- Requirement of a methodology that can be customized for identifying the Gaps in Care
- Inadequacy of reporting on process and clinical execution only
- Lack of knowledge about the real financial value of a program
- Demand for routine accurate and credible reports validating the program and investment
PROFormance supplies:
- Data illustrating the financial performance of disease management programs
- Basis for identification of Gaps in Care in the implementation of disease and care management programs
- Support for specific internal and external reporting requirements
- Functionality for logical selection and documentation of confounding variables and assumptions
- User-friendly features so adjustments can be executed without programmer involvement
- Access to a robust database of claims, enrollment data, and methodological adjustments
- Capability to produce specific cost-effective ROI studies
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Enhancing the credibility of calculated financial savings results
Understanding the underlying assumptions
and methods that have been employed in
the calculations
Comparing results between different programs and suppliers
Determining whether calculations comply
with DMAA guidelines and other industry
best practices
Obtaining necessary audit trail information for a calculated result
Cost effective auditing or reproducing a vendor's calculated results
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PROFormance calculations have been tested and validated, so that users can have confidence in the results. A standard audit trail is provided to allow users to replicate results easily from initial input
PROFormance provides a logical walk-through of all key assumptions, which are documented in the resulting report
Once data are loaded into PROFormance, running comparisons between programs and populations is straightforward. The PROFormance process ensures that the same methods and assumptions are applied to all populations and data
Although PROFormance is flexible and can support multiple methodologies, if required the primary methodology supported is consistent with DMAA's guidelines, the most-frequently used methodology in the industry
PROFormance automatically generates an audit trail,
enabling follow-up and validation of results
PROFormance may be used with any dataset to
replicate or validate reported results
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- Reports on financial and clinical performance of disease management programs
- Helps identifying Gaps in Care based on customizable clinical conditions
- Provides consistent methodology with a demonstrable audit trail to source data
- Simplifies studies without compromising the integrity of outcomes
- Supports specific internal and external reporting requirements
- Allows access to a robust database of claims, enrollment information, and methodological adjustments
- Uses logical selection and documentation of confounding variables and assumptions to construct comparison and intervention groups
- Supports the DMAA Evaluation Guidelines methodology
- Offers small-employer ROI reporting methodologies
- Enables clients to easily execute adjustments without programmer involvement
- Integrates with SCIOinspire's PROGuide and PROSpect software
- Flyer - PROFormance Care Management Employer Financial and Clinical Outcomes Reporting Application
- White Paper - PROFormance Evaluating Wellness Programs
