SAN MATEO, Calif.--(BUSINESS WIRE)--CCGroup has several patents protecting its physician efficiency methodology and system. Other patent applications are awaiting approval. The most recent patent was issued in May 2017.
“CCGroup has invested significant time and effort to determine and develop the most appropriate methods to obtain reliable and stable physician efficiency scores. Our approach is narrowly defined, and one of many efficiency methodologies available on the market today,” defined Dr. Douglas G. Cave, President of CCGroup.
The foundation of the CCGroup patent family is using a predefined or relevant set of medical conditions for a specialty type and calculating weighted episode of care across a predefined set of medical conditions. Other claims include the following: form medical condition episodes of care; assign episodes of care to a provider; calculate medical condition-specific episode of care statistics; calculate weighted episode of care statistics across medical conditions using a predefined set of medical conditions for a PCP or specialist; and determine efficiency scores for providers from the calculated weighted episode of care statistics for the provider and for the peer group.
“We are defending our patent rights on CCGroup’s specific physician efficiency scoring. For example, a federal jury in April 2015 awarded CCGroup more than $12 million after determining that UnitedHealth Group’s subsidiary OptumInsight infringed CCGroup’s patent for measuring physician efficiency; the product name is Impact Intelligence. Also, CCGroup is presently in federal court with Truven Health Analytics, a subsidiary of IBM Watson Health; the product name is Physician Performance Assessment,” discussed Dr. Cave.
He continued, “Some competitors may feel they are not infringing if they include either more medical conditions or sicker patient episodes of care within the predefined, relevant set of medical conditions.” However, the many specialty-specific marketbaskets listed in the embodiment of our patents are just exemplary, and the use of other relevant sets of medical conditions can still fall within the scope of our patents.
“Similarly, including sicker patients does not necessarily avoid infringement. Other competitors may feel they are not infringing if they include an additional patient case-mix adjustment during the process of calculating the overall physician efficiency score. But, the claims merely require determining overall efficiency scores for physicians from the calculated weighted episode of care statistics for the physician and for the peer group. The fact that an analytical tool may incorporate additional patient case-mix adjustments does not avoid potential infringement,” stated Dr. Cave.
CCGroup would like to encourage you to contact us if you believe you may require a license to the CCGroup efficiency measurement patent family. We recognize that our narrowly defined approach is just one of many physician efficiency methodologies being applied in the market today, but the approach provides valuable increased stability and is becoming widely adopted for that reason.
About Cave Consulting Group, Inc. (CCGroup)
Cave Consulting Group, Inc. is a software and consulting firm located in San Mateo, California. The company is focused on improving the efficiency (cost-of-care) and effectiveness (quality-of-care) of the healthcare delivery system. Senior management of CCGroup has assessed the performance of physicians and hospitals for over 27 years for health plans, HMOs, physician groups, health systems, TPAs, and employers.