May 22 2018

John Muir Health Partners with Clarify Health to Benefit Patients and Optimize Performance in Value-Based Care

Bay Area health system proves exceptional quality can go hand-in-hand with delivering more affordable care using Clarify Care Prism Analytics

SAN FRANCISCO, CA – May 22, 2018 /BUSINESS WIRE/ – Clarify Health Solutions, Inc., a pioneer in machine learning-enabled care optimization, today announced that John Muir Health (JMH) has renewed its contract for Clarify’s advanced analytics platform, Care Prism.

John Muir Health is one of the largest CMS Total Joint Replacement (TJR) providers in the San Francisco Bay Area, with an annual volume of 750 CMS TJR cases. In 2016, JMH was selected for participation in CMS’ mandatory Comprehensive Care for Joint Replacement (CJR) bundled payment model.

The CJR model holds participants accountable for the quality and cost of an entire episode of care – that starts with a patient’s admission to a participant hospital and ends 90 days post-discharge. Each year during the program, CJR hospitals are given set episode target prices and quality goals. At the end of a model performance year, actual spending for the episode is compared to the target price and depending on the participant’s quality and episode spending performance, the hospital may receive a bonus or penalty from Medicare (CMS).

Leaders at John Muir Health quickly realized their traditional labor-intensive methods of analysis would not be sufficient to monitor performance in the program. The team needed a solution to generate actionable insights to engage physicians to change behavior that would deliver both improved care and savings.

The choice to implement Care Prism was based on the intuitive nature of the platform, its precise case-mix adjustment, and AI-generated insights, as well as the support provided by the Clarify clinical transformation and implementation team. From first login, John Muir Health had a detailed view of its operational and financial performance at the facility, individual physician, and affiliated partner (e.g., skilled nursing facility) level. The team was able to identify relevant variation and generated specific improvement insights while still cutting the time required to process data and generate reports by over 50%.

“Clarify’s solution provides the critical analytical foundation for our bundled payments program,” said Patty Haggen, Executive Director of Hospital Operations and Orthopedics, John Muir Health. “It delivers the actionable insights we need to help our physicians and care team deliver high quality and more affordable care for our patients. Ultimately, we look for solutions that are going to benefit our patients and the communities we serve and Clarify was able to partner with us to deliver on that goal. The lessons learned and best practices are ones that we want to continue to expand on and implement across our health system.”

John Muir Health scored an excellent rating on quality, confirming that providing exceptional quality can go hand-in-hand with delivering more affordable care. This is particularly notable as they are one of the highest-volume total joint replacement (TJR) providers in the Pacific region, which happens to be one of the most resource efficient regions in the United States.

“Value-based payment models are redefining our industry. John Muir Health is a perfect example of a health system that has seized opportunity in CJR and realized significant improvement,” said Jean Drouin, MD, CEO and co-founder of Clarify Health. “We are proud to support the John Muir Health team to deliver better and more affordable healthcare in the Bay Area. We’re looking forward to the future as we expand our partnership.”

For more information on the partnership between John Muir Health and Clarify, please read our case study.

About John Muir Health
John Muir Health is a nationally recognized, not-for-profit health care organization east of San Francisco serving patients in Contra Costa, eastern Alameda and southern Solano Counties. It includes a network of more than 1,000 primary care and specialty physicians, nearly 6,000 employees, medical centers in Concord and Walnut Creek, including Contra Costa County’s only trauma center, and a Behavioral Health Center. John Muir Health also has partnerships with Tenet Healthcare/San Ramon Regional Medical Center, UCSF Health and Stanford Children’s Health to expand its capabilities, increase access to services and better serve patients. The health system offers a full-range of medical services, including primary care, outpatient and imaging services, and is widely recognized as a leader in many specialties – neurosciences, orthopedic, cancer, cardiovascular, trauma, emergency, pediatrics and high-risk obstetrics care.

About Clarify Health
Our vision is to power better care by personalizing and optimizing every care journey. Clarify Health delivers the insights and digital solutions that empower physicians, health systems, and payers to optimize care and thrive in a value-based world. The Clarify Health platform seamlessly integrates powerful analytics, artificial intelligence, real-time patient navigation, and smart workflows to proactively guide patients and their caregivers through personalized care journeys. Clarify Health brings together committed and passionate colleagues with backgrounds in big data and AI engineering from financial services together with extensive clinical operations expertise. The team has a track record of achieving over $1 billion in improvement at more than 125 health systems, payers, and pharmaceutical companies, and deploying cloud-based software at over 5,000 institutions.

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