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What is HealthCorum's definition of a 'low-value' care (treatment)?
HealthCorum process identifies a treatment as low-value if one of the conditions below is true:

A. The treatment is medically unnecessary.
B. The benefits are short-term.
C. A lower-cost alternative is available.

Can HealthCorum use our internal data?

Absolutely! HealthCorum platform is equipped to analyze claims and create scores based on client data. There are some basic guidelines and minimal required fields that any dataset should contain. HealthCorum’s scores are designed to harness the richness and homogeneity of CMS data covering significant portions of the physician’s patient’s panel. However, we understand the value and fit-for-purpose use of our partners’ own data, which is reflective of the physician patterns through the lens of their own populations. While CMS-based scores establish a good foundation for understanding physician groups’ relative appropriateness for value-based arrangements, we recommend fine-tuning interventions/strategies based on scores derived from your own population.

Many of our providers have multiple specialties. How does HealthCorum determine specialties for peer-to-peer comparison?
Our proprietary algorithms assign specialties/subspecialties to providers based on how they spend their time and the drugs they prescribe observed in the claims data. The algorithms further break up diverse specialties (such as orthopedics, internal medicine, and cardiology) into subspecialties. For example, HealthCorum compares orthopedic surgeons’ practice patterns who primarily perform hip surgeries to other hip surgeons in the same geographic area, serving a similar population. Internal medicine physicians with activity like nephrologists are classified as nephrology versus internal medicine providers who function as primary care.
How does HealthCorum account for regional variations?
HealthCorum uses Hospital Referral Regions (HRR) to define peer group geographies. The HRR is a geographic unit used by the Dartmouth Atlas for health care to define the hospital service area containing the referral hospital or hospitals most often used by residents of the region. CMS, HealthCorum, and many other organizations use this geographical framework to make comparisons.

Does HealthCorum use Personal Health Information (PHI)?
HealthCorum does not use or accept PHI data. A unique identifier provided in the dataset is used to build relational data.