Onpoint & Dartmouth Institute Study Published in the American Journal of Managed Care

Onpoint recently collaborated with HealthPartners and Blue Cross Blue Shields of Michigan and Texas in a project led by the Dartmouth Institute (TDI). The study, "Tracking Spending Among Commercially Insured Beneficiaries Using a Distributed Data Model," in which the researchers applied the HealthPartners' Total Cost of Care measurement system to commercial claims data across five states, was recently published this past September in the American Journal of Managed Care.

The HP software, endorsed by the National Quality Forum (NQF), measures utilization using "Total Care Relative Resource Values" (TCRRVs). Unlike some "total cost of care" measures that simply sum payments, TCRRVs combine resource use across different service lines (inpatient, outpatient, professional, pharmacy) while adjusting for frequency and intensity of use. The TCRRVs become a measure of the cost of healthcare independent of price variation.

The study features a map comparing variation in per capita TCRRV rates by hospital service areas across three states that provided data from multiple insurers: Maine, New Hampshire, and Vermont. The authors then calculated the correlation between commercial and Medicare reimbursements and utilization. Onpoint's use of the three-state northern New England APCDs represented the first application of HealthPartners' software to a multi-state APCD.

Overall findings demonstrated substantial variation in utilization. The study also revealed that variation patterns in the commercial population did not necessarily mirror trends in the Medicare population for total use, though they were correlated for inpatient use. Click here to read the full article.