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   CareMaps analysis of New Mexico Medicaid healthcare claims for 2010-2014
  Are care programs in place where needed?
  CareMaps analysis points out specific medical needs of counties making it possible to implement care programs cost efficiently.
  Relentless focus on effectiveness
  CareMaps can rapidly detect effective programs and replicating them will improve the health of a community. Getting rid of ineffective programs will save money and cause less damage to the health of a community.
  Increase accountability
  CareMaps is able to associate onset of chronic and comorbid conditions to the ineffectiveness of wellness programs, PCP management or coordination of care, making it easier to devise corrective actions.
  Interpret and demystify premiums
  CareMaps translates premium values to treatment costs for various chronic conditions and cancer, and we found a surprising 20% variation in costs across the State for treatment costs for the same chronic disease. This exposed the fallacy of the "They are sicker" excuse of actuaries. If costs of treatment everywhere were brought to the lowest level, the state could save several hundreds of millions of dollars yearly.
  National report cards of best and weak programs
  Using CareMaps we are able to create a report card listing best practices in various regions of the state, both for best outcomes and lowest costs of treatments for various chronic and cancer patients. The comparative assessment of the chronic health of populations and treatment programs introduces peer pressure in communities to outperform their neighbors, and generally improve the performance of care programs and the health of populations.
  Forecasting Chronic and Cancer Populations
  At the heart of CareMaps is a powerful tool to forecast the spread of chronic populations and their costs of treatment. In the sample populations studied, the error rates in 12-month predictions were less than 5%. These are dynamical forecasts and not statistical.
 Fraud & Abuse - Digital Forensics™  
 The combination of forecasting and interpretation of premiums in terms of costs of treatment makes CareMaps a powerful audit tool for identifying fraud and abuse, both contemporaneously and after the fact. The analysis includes the totality of healthcare claims and so the usual criticism of audits, that they extrapolate results based on a select sample, is no longer valid. Digital Forensics™ is the term we have coined to describe this type of remote electronic monitoring of fraud and abuse using CareMaps. 
Copyright 2006, 2011, 2019. Physmark, Inc. Corrales, NM.