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Cleveland firm the latest to ready a pay-for-performance software tool

Pay for performance? There’s an app for that. Cleveland’s CHAMPS Management Services joins a series of companies nationwide trying try get a head start on serving pay-for-performance, an increasingly popular potential solution to improving care and cutting costs. Yet while the apps are here, pay for performance isn’t — at least not yet.

CLEVELAND, Ohio — Pay for performance? There’s an app for that.

Cleveland’s CHAMPS Management Services joins a series of companies nationwide trying try get a head-start on serving the pay-for-performance market, an increasingly popular potential solution for improving health care and cutting costs, and one likely to be required by health care reform legislation.

CHAMPS’ product — called CurePath — will incorporate publicly reported data as well as other benchmarks from a health system to create a guide doctors can use to see and compare cases around an agreed-upon standard of care. CurePath should launch by year’s end, and will focus first on breast and colon cancer. It will later include services for prostate and lung cancers.

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“We continue to inch [toward] pay for performance,” said Bill Ryan, chief executive officer for the Center for Health Affairs, a trade association for Northeast Ohio hospitals that also oversees CHAMPS. “The ability of institutions to document treatment in a simple way is going to be significant in this kind of world.”

CHAMPS is a management and consulting firm that already offered a data management service for oncologists, and will offer CurePath as part of its service to the same clients. A CurePath report would, for example, break down cancers by stage as well as by other clinical distinctions, and would filter cases by age, race, survival rate, type of payer and other factors. The Web-based software would display how many cases followed the standard of care and how many  did not. Users could then click into either category to figure out why a case fit either category.

The software won’t only show when health systems comply, but by displaying the data, it also would give health systems more control over doctors’ conduct, Ryan said. Hospitals — not the physicians — lose reimbursements because of health-care reform programs including pay for performance and Recovery Audit Contractor program. Having a way for physicians to access basic treatment standards would let hospitals guide the doctors away from certain (non-reimbursable) approaches, Ryan said.

One of several concerns about pay for performance is that it would discourage new and innovative techniques, unique treatments for specific cases, and possibly the treatment of some patients. CHAMPS executives said their software would incorporate physician notes into a system so that explanations about exceptions to traditional care and unique treatments could be justified and not penalized.

Yet while the applications like CurePath are here, pay-for-performance isn’t — at least not yet. There are scores of pilot projects, research and small attempts at using the pay-for-performance model. But a final, universal version is far away, which has made it hard to sell software related to the practice.

“It’s incredibly difficult,” said Don Thomas, the chief executive officer of SoftLight Development. The Texas company two years ago offered pay-for-performance features in its electronic health records service. Less than 10 percent of its customers use the option.

“There’s a lot of data, but a lot of unknowns,” Thomas said. “And there’s a lot [of issues], from a physician’s standpoint. You see it spearheaded [by] insurance companies, but you don’t see any ownership outside of that.”

Plus, health-focused providers of the software would see competition from companies like Callidus Software, which focuses on pay-for-performance in sales, and in industries like banking and telecommunications. That company also is planning to get into the health-care space, said Jimmy Duan, a senior vice president who oversees business process management and software-as-a-service products.

“I don’t think they’re going to understand the process,” Duan said of health-care consultants and software providers. Eventually, health-care companies may have to change the way doctors are compensated or deal directly with doctors to manage a pay-for-performance mode, he said.

CHAMPS officials said there are other uses for a data-mining service like CurePath. Gathering pay-for-performance data could provide leverage when negotiating managed-care contracts, help insurers better understand why certain cases don’t match with standards of care, and help hospitals meet requirements by the Commission on Cancer to assess treatment patterns.

Michelle Fancher, vice president for communication at the Center for Health Affairs, said CHAMPS would use CurePath as a quality improvement tool that will grow into a pay-for-performance aid as that trend reaches cancer practices.

“Once you address the quality side, you’re ready to address pay-for-performance,” Fancher said.

[Photo courtesy of Flickr user SarahMcD]