As Chief Medical Officer at BaseHealth, Dr. Nick van Terheyden (aka “Dr. Nick“) serves as the voice of the physician at the company. He provides strategic insights in product development and marketing as BaseHealth works to bring to market a predictive, evidence-based and data-driven population health management platform.
Base Health is working from the ground up to build a new approach to population health, focusing on the individual patient, what Base Health calls “the invisible patient.” This is the individual we all know exists who is going to have a catastrophic interaction with the health care system but we don’t yet know who and what – this is the patient who presents in the emergency room with a significant clinical problem leading to costly treatments and significant long term health issues. As Dr. Nick says, “We find the patient before that takes place.”
I spoke with Nick about his new role at Base Health, and he is very excited. Dr. Nick says that the way we practice medicine today is riskier than it needs to be. He likens relying on claims data alone (as he posits many health systems currently do, in their efforts to manage patient health) to driving down the highway while looking in the rear view mirror. Instead he urges that we must Look at the EHR, at Rx data, appointment data, anything that exists about the patient, and assemble it in one place, and examine it carefully. Base Health combines more comprehensive information about individuals and analyzes it using its machine learning knowledgebase including all 150 million-plus medical papers in the PubMed database.
Using these tools, BaseHealth is able in 90% of cases to accurately “risk-adjust” a patient population, thereby enabling the clinical care system to focus its efforts on providing preventive services to those at greatest risk. The system has been implemented at Banner Health, for certain conditions, in the Medicare Advantage population, after Banner tested the BaseHealth algorithms by applying them to old data about patients that had been followed at Banner. BaseHealth predictions based on the old data closely tracked actual experience in the same cohort of patients.
By providing more accurate risk adjustment, Banner Health says it is able to provide a positive ROI for the payor and provider organizations, and benefits to the patients as well. If previously under-reported risk is reported accurately earlier, the Medicare Advantage plan and a risk-bearing provider organization would be paid a higher risk-adjusted capitation rate earlier in time, giving them a longer runway of greater resources to use to address the unmet needs of the invisible patient.
Please have a listen to learn more.
I spoke with Nick as part of my ongoing series of fireside chats with healthcare innovation leaders – Harlow on Healthcare, on HealthcareNOW Radio. You can catch me live weekdays at 8:30 am, 4:30 pm and 12:30 am ET. As each new show goes live, the last one joins the archive, available via SoundCloud or your favorite podcast app (iTunes, Stitcher). Your comments are welcome here. Join the conversation on Twitter at #HarlowOnHC.
David Harlow
The Harlow Group LLC
Health Care Law and Consulting
You wrote:
“Using these tools, BaseHealth is able in 90% of cases to accurately “risk-adjust” a patient population, thereby enabling the clinical care system to focus its efforts on providing preventive services to those at greatest risk. The system has been implemented at Banner Health, for certain conditions, in the Medicare Advantage population, after Banner tested the BaseHealth algorithms by applying them to old data about patients that had been followed at Banner. BaseHealth predictions based on the old data closely tracked actual experience in the same cohort of patients.”
How amusing. This is something the lowly pediatrician has been doing for ages. We have done it for 14-15 years on an EMR – we even do it now, and I regularly bust the chops of our 3rd party payer reps who come by to tell us what we should improve. Their data is (I do not exaggerate) 2 months old, and I throw it back at them and say “we have already fixed all or 90% of those problems.” I know this because I used to chase those reports down, and now, I know it is a waste of time.
If the health system wants to improve, CLAIMS DATA IS NOT ENOUGH. Rear view mirror is right.
But nobody pays for that. The reason we do it is because our providers get awakened at night, so they have a motivation. It’s all about the pain point.