Healthcare Payment Reform
Our primary mission is to create and apply tools for restructuring the current dysfunctional healthcare market so that coordinated, cost-effective care is rewarded. Our component-based episode infrastructure (patent pending) creates a nuanced representation of health care to which sophisticated analytic techniques are applied to identify and reward high-performance healthcare providers.
Patient-Centered Virtual HMO
Based on principles and methods incorporated in our component-based healthcare episode infrastructure, our team can help organizations create patient-centered virtual HMOs. These virtual HMOs combine unlimited patient choice with a sophisticated system of reference pricing for evidence-based required services and for bundles of individualized episodes of care.
Consulting Services
Our expertise and experience enable our team to adapt the novel principles and methods incorporated in our component-based healthcare episode infrastructure to create solutions that will help clients prosper in a rapidly evolving healthcare marketplace.
Leadership in Healthcare Payment Reform
The success of modern medicine in combatting disease has been accompanied by increasing complexity that requires a high degree of specialization. Fragmentation and lack of coordination have compromised clinical effectiveness and fostered redundant, potentially harmful care. Dysfunctional financial incentives have exacerbated these problems by inadequately reimbursing providers of coordinated cost-effective care, while often rewarding providers of healthcare services that do little to improve clinical outcomes.
MJP’s unique, component-based healthcare episode infrastructure (patent pending) transforms standard or clinically enhanced claims data into a highly nuanced representation of clinical care. This representation is structured to support sophisticated analyses of comparative risk-adjusted costs and outcomes of care. Results of these analyses are used to set risk-adjusted reference prices for evidence-based required services and bundled individualized services, to evaluate clinical quality, and to determine final payments to healthcare providers. This system provides a comprehensive, integrated, objective, patient-centered method of payment for healthcare services. It respects patient choice and physician autonomy while financially rewarding providers of coordinated cost-effective healthcare.