The KPI Ninja report on Nextera’s school district program claims big savings when employees chose Nextera’s direct primary care rather than traditional primary care. But the analysis reflects inadequacy of a high order. Here’s a starter course of cluelessness, actually one the report’s smaller problems.
The report ignored the effect of an HRA made available to non-Nextera members only. But $750 in first dollar coverage gets a cost-conscious non-Nextera employee a lot of cost-barrier-free primary care for her chronic condition. And, unlike the dollars the SVVSD spends at Nextera, every HRA dollar the district covers for a non-Nextera employee still applies to her deductible.
Is Nextera the best choice for her?
If she’s a math teacher at Longmont High, the odds are extremely high that she’ll figure this out, then reject Nextera.
No one, not even a KPI Ninja, can make sense of the SVVSD’s programs without considering the profound effect of the HRA — shifting costs, shifting utilization, and shifting member plan selection.
Fun – duh – mentals of plan comparison
You cannot accurately assess cost differences between plans without addressing significant differences in plan benefit design.
You cannot accurately assess utilization differences between plans without addressing significant differences in plan benefit design.
You cannot accurately assess selection bias between plans without addressing significant differences in plan benefit design.
A $750 HRA is a significant difference in plan benefit design, large enough to seriously affect a $913 savings claim.
The KPI Ninja report failed to address the HRA. For that reason alone, one might think it reasonable to disregard the report in its entirety.
But that might be too fair to KPI Ninja and Nextera. There’s lots more and it gets worse. The KPI Ninja/Nextera report is nonsense piled high.
The HRA issue and many others are discussed at length in these five posts:
KPI Ninja/Nextera report: every single cost comparison has an 10% “benefit design” error describes how in his “School District Claims Analysis“, the actual Analyst overlooked key differences in how the actual “School District” pays actual “Claims“.
KPI Ninja’s Nextera Risk Measurement Charade focuses on the study’s major failure on population health measurement issues. While Nextera and KPI Ninja bragged of risk adjustment performed by an academic research team, neither the team and nor the risk adjustment were real.
Nextera did not reduce inpatient hospital admissions by 92.7% focuses on a single astonishing utilization claim from the Nextera report, that might reflect a severe error in basic data collection — one that just by itself would account for every penny of the claimed savings. Or is it just cherry-picking at the Olympic level?
KPI Ninja’s Nextera analysis: more than enough problems collects many of the study’s other problems relating to design, data limitations, induced utlitization and so on. There are many deep cutting deficiencies in the Nextra report.
Nextera’s Next Era in Cherry-Picking Machine Design focuses on the need for any report on the SVVSD plan to reflect the differences in benefit design. Although updated recently to bridge to the published report, its core content predates the published report by months, and it was shared in early summer 2020 with both KPI Ninja and Nextera.
Engage.
By some reckoning, this is the 100th post on dpcreferee.com.
DPC Referee 