SAN MATEO, Calif.--(BUSINESS WIRE)--Nationally over 230,000 primary care physicians (PCPs) and specialists are evaluated based on achieving acceptable clinical protocol ranges in treating medical conditions (or Clinical MedMarker Protocol Ranges™). “CCGroup works with CCGroup National Specialist Panels on an ongoing basis. This effort helps to ensure the validity of established Clinical MedMarker Protocol Ranges™,” stated Dr. Douglas G. Cave, President of CCGroup.
Dr. Cave continued, “MedMarkers™ are process of care quality measures, well-defined in clinical guidelines. However, they also are the key services and procedures most associated with cost-of-care in treating a medical condition. MRI of spine is the main MedMarker™ (or correlated service) in treating low back pain; and upper gastrointestinal (GI) endoscopy is the main MedMarker™ in treating GERD (or heartburn). MedMarkers™ technology is protected under USPTO Patent Numbers 8,301,464 and 8,751,263.”
“Clinical MedMarker Protocol Ranges™ are achievable and clinically appropriate ranges of clinical practice for a MedMarker™. These ranges are developed by presenting the CCGroup National Comparative MedMarker™ Database results to our CCGroup National Specialist Panels. Specialists on a CCGroup National Specialist Panel need to have an academic appointment or affiliation at a targeted, well-respected U.S. medical school,” asserted Dr. Cave.
Each specialist on a CCGroup National Specialist Panel is asked to review medical condition-specific MedMarker™ results. Then, they define the percentage of patients where a MedMarker™ service is likely clinically warranted. The specialists also are instructed to ensure the percentage of patients is not too low to represent underutilization of care.
Dr. Cave stated, “Based on the CCGroup National Specialist Panel results, the appropriate Clinical MedMarker Protocol Range™ is selected for each medical condition. For example, the acceptable Clinical MedMarker Protocol Range™ for routine low back pain is no more than 0-to-20 out of every 100 episodes with an MRI of spine.”
MedMarkers™ and Clinical MedMarker Protocol Ranges™ are important for value-based payment programs. “Providers want to understand the services they need to focus on to reduce unwarranted practice variations. The medical condition-specific MedMarkers™ answer this need. Also, providers want to know the appropriate level of utilization that does not represent potential under-utilization of services. Clinical MedMarker Protocol Ranges™ answer this latter question,” defined Dr. Cave.
CCGroup recently re-surveyed the cardiology, orthopedic, and gastroenterology CCGroup National Specialist Panels. This effort is an important part of CCGroup’s ongoing plan to support established Clinical MedMarker Protocol Ranges™. “Based on re-survey results, there are few-if-any changes to the existing Clinical MedMarker Protocol Ranges™. For example, the established Range for GERD (the medical condition) is 10-to-35 out of every 100 episodes with an upper GI endoscopy (the MedMarker™). Our recent re-survey confirms that this is an acceptable clinical range,” declared Dr. Cave.
For each health system and provider group, MedMarkers™ and Clinical MedMarker Protocol Ranges™: prioritize the services to work on first; quantify the savings from reduced practice variations; and allow healthcare organizations to annually monitor and quantify the success of their implemented value-based payment programs.
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 26 years for health plans, HMOs, physician groups, health systems, TPAs, and employers.