Resolution Health to Assess Quality of Care for Nation’s Largest Physician Profiling Initiative

Resolution Health Inc. (RHI), a provider of health care data analysis and targeted member and physician messaging services, has been selected to assess the quality of care provided by individual physicians and physician groups in the largest private or pu

Columbia, Md. — Nov. 6
Resolution Health Inc. (RHI), a provider of health care data analysis and targeted member and physician messaging services, has been selected to assess the quality of care provided by individual physicians and physician groups in the largest private or public clinical performance measurement initiative in the nation, sponsored by Care Focused Purchasing Inc. (CFP).

Three years in the making, CFP represents a coalition of major insurance carriers and more than 50 national self-insured employers who will contribute de-identified medical and pharmacy claims data for an evaluation of the quality and efficiency of care provided by physicians to their members and employees across the United States.

Formally incorporated as a not-for-profit entity in mid-2005, CFP’s member employers, many of them Fortune 100 companies, are united in the belief that the solution to America’s health care cost crisis lies in higher quality and more efficient medical care.

CFP has signed agreements to partner with seven major health plans, including Aetna, CIGNA, Fiserv Health, Humana, Preferred Care, Regence BlueShield and WellPoint (Anthem BlueCross Blue Shield), which will provide claims data on more than 18 million members.

This data will then be combined in a “data warehouse” with claims data related to more than 2 million self-insured lives from the CFP employers.

“Given the importance of CFP, we needed to identify an entity with substantial expertise and experience in analysis of claims data to perform our evaluation of quality of care,” said Dr. Alan Spiro of WellPoint Inc. “Following a thorough assessment of potentially qualified vendors, we selected Resolution Health to perform this work because of the clinical and methodological sophistication of its approach to clinical performance measurement. RHI will enable CFP to achieve its goal of developing an assessment of the quality of care delivered by individual physicians and physician groups based on comparison of actual practice to evidence-based clinical practice guidelines.”

Earl P. Steinberg, MD, MPP, president and CEO of RHI, and adjunct professor of medicine and of health policy and management at Johns Hopkins University, agrees.

“Given the wide variation in the quality and cost of health care in the U.S. and payers’ and consumers’ growing interest in meaningful measures of provider performance, we are pleased to have been selected by CFP and its advisors to perform the analysis of quality of care for this groundbreaking project,” Steinberg said.

Robert Ihrie of Lowe’s Companies Inc. agress.

“Members of CFP share a common concern about escalating health care costs, inconsistent quality, varied outcomes and unacceptable error rates in the care delivered to employees and their families,” Ihrie said. “This far-reaching physician profiling project moves CFP closer to its goal of improving both the quality and efficiency of health care through better information regarding provider performance.”