Summary
Examination of primary care claims data can help signal potential vulnerabilities during multiple phases of the patient care continuum.
This article belongs to the Coverys Red Signal Report SM series.
The role of the primary care doctor has become increasingly important and challenging. Primary care physicians impact all aspects of their healthcare systems’ quality, patient satisfaction metrics, and risk exposures. They are accountable for all aspects of the patient care continuum. This includes referral management, management of multi-morbidities, etc., while keeping a sharp eye on utilization, appropriate level of care, and patient satisfaction.
The report provides a unique perspective on the challenges primary care physicians deal with every day. The report integrates claims data analytics, risk assessment, and best practice solutions into a concise report. It demonstrates how important risk management focus areas overlap with patient safety metrics (e.g. MACRA and MIPS) and provides risk recommendations that align with quality measures.
Copyrighted. No legal or medical advice intended. This article includes general risk management guidelines. Such materials are for informational purposes only and may not reflect the most current legal or medical developments. These informational materials are not intended, and must not be taken, as legal or medical advice on any particular set of facts or circumstances.