UnitedHealthcare, one of the largest U.S. health insurers, and three big healthcare systems -- Baylor Health Care System in Dallas, Dignity Health in San Francisco, and Advocate Health Care in Illinois -- have formed a new company, SharedClarity that will combine United's claims data with clinical data to find out which devices perform the best and produce the best patient outcomes. The company will study artificial hips and knees, pacemakers, heart valves, defibrillators and stents, among other devices.
Although device manufacturers have funded studies comparing the effectiveness of certain kinds of devices, this is believed to be the first time that providers have joined forces with an insurance company to do independent studies of medical device effectiveness.
The three founding provider organizations of SharedClarity together care for about 7 million patients a year at more than 850 locations across the country. In an announcement, SharedClarity said that it plans to recruit additional provider organizations in coming months.
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Optum Labs, a joint venture between UnitedHealth Group subsidiary Optum and the Mayo Clinic, will provide the scientific know-how to do the studies in collaboration with clinicians from the participating health systems. The Lewin Group, another part of Optum, will oversee the research.
Besides resulting in better patient care, the members of SharedClarity believe the studies will save money, said Mark West, president of SharedClarity, in an interview with InformationWeek Healthcare. The affordability of individual devices will be evaluated, he said, based not only on much they cost initially, but also on the number of complications and readmissions associated with their use.
The members of SharedClarity will also pool their purchasing power to negotiate with device makers through the joint venture, using the results of the comparative effectiveness studies. Although the three health systems by themselves might not have much bargaining clout, SharedClarity will also represent United, which provides health benefits to more than 40 million people, said West.
Referring to these future negotiations with device makers, West said, "There will be two price tiers. One will be global for the SharedClarity members. The second price tier will be available to United's network providers. So it's an offering that United can offer its network providers to improve the affordability of medical devices."
A spokesman for the Medical Device Manufacturers Association (MDMA) could not be reached for comment at press time.
When Optum Labs was formed a few months ago, that company said it would make public the results of its research on improving the quality and lowering the cost of care. But West said that the members of SharedClarity are still evaluating whether and when they'll publish the results of their studies.
With the help of Optum Labs, the company will figure out how to combine United's claims data with clinical data from the providers' disparate systems -- a feat that has required a big data approach in some organizations. Among other things, West said, the provider members will have to determine how to pull data showing which devices from which manufacturers were implanted in each patient, "which is a blind spot in the data that United has." In addition, clinical data on outcomes will have to be collected and aggregated.
If the research shows that a particular device is harmful or has a significantly higher rate of complications than do other devices in the same category, "we have a moral and ethical responsibility" to do something about it, West said. SharedClarity has formed a quality and ethics committee to address issues like this. But the members haven't decided what the proper forum would be or whether to pass on information about faulty devices to the Food & Drug Administration (FDA), he said.
SharedClarity is the outgrowth of discussions that started several years ago between United and Dignity Health, then called Catholic Healthcare West, noted West. In the news release, Richard Roth, VP of strategic innovation for Dignity Health, said, "We have a responsibility as providers and insurers to deliver the highest quality, most affordable care possible. In joining together to form SharedClarity we are building a platform that will give doctors, hospitals, and insurers the information we need to make evidence-based decisions about the care we are providing."
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