Nextera and Paladina: a race to the top of Mount Brag

In 2015, Qliance still towered over all in the world of Direct Primary Care bragging with its claim of 20% overall cost reductions. Even that, of course, was quite a come down from the extravagant claims previously spewed under the Qliance banner; fond memories still linger of those heady days when the Heritage Foundation drooledContinue reading “Nextera and Paladina: a race to the top of Mount Brag”

In rural areas, decreased primary care panel size is a problem, not a solution.

Montana’s last governor twice vetoed DPC legislation. He was not wrong. Over the last month or so, DPC advocates from think-tanks of the right have trotted out the proposition that direct primary care could be “the key to addressing disparities in health care access in underserved areas of Montana facing severe shortages of primary care”.Continue reading “In rural areas, decreased primary care panel size is a problem, not a solution.”

Shorter KPI Ninja/Nextera SVVSD report

“We used a statistically valid risk measurement tool and determined that there was a a non-Nextera population had a 7.5% difference greater level of risk then our Nextera population. But don’t believe that result, because it was not statistically valid.” “We reduced inpatient hospital 92.7%. Want to know how great we are? Our statistically validContinue reading “Shorter KPI Ninja/Nextera SVVSD report”

Nextera brags about THIS? Really?

In its recent report from KPI Ninja, Nextera Healthcare bragged unpersuasively about overall costs savings and reduced utilization of downstream care services. But they also bragged about the following utilization figures for a group of 754 members for whose primary care they were paid $580,868 in DPC subscription fees over the equivalent of a ten-monthContinue reading “Nextera brags about THIS? Really?”

KPI Ninja/Nextera report: every single cost comparison has a 10% benefit design error.

In KPI Ninja’s “School District Claims Analysis” comparing claims costs under the Nextera plan and the competing fee for service (Choice) plan, the “Analyst” overlooked two major differences between the plans in how the “School District” pays “Claims“.   Nextera members pay post-deductible coinsurance at a 20% rate and the district pays an 80% share. ButContinue reading “KPI Ninja/Nextera report: every single cost comparison has a 10% benefit design error.”

KPI Ninja’s Nextera risk measurement charade

Abstract: The Nextera “study” by KPI Ninja misappropriated the prestige of a Johns Hopkins research team to support its risk measurement claims; relied on an undisclosed and unvalidated methodology for obtaining population risk measurements; obtained highly dubious risk measurement results; and sharply mischaracterized the significance of those results. In the end, because applying even theirContinue reading “KPI Ninja’s Nextera risk measurement charade”

KPI Ninja’s Nextera analysis: more than enough problems.

Three major adjustments are needed, even without correcting the IP admit rate problem or arriving at a more reasonable risk adjustment. Comparing data from Nextera patients and non-Nextera patients in the SVVSD programs requires three major adjustments which KPI Ninja never attempted. Computations here. Because of the different benefit structures, the district’s claim costs forContinue reading “KPI Ninja’s Nextera analysis: more than enough problems.”

FFS primary care is higher quality than DPC. “Proved.”

One pet theme of most D-PCPs is, “Who can better determine quality better than my patient?”, a question invariably coupled to its speaker’s brag about a high patient retention rate. And yet, in the Union County employee DPC clinic study, the actuaries observed a huge risk selection bias against the DPC, enough to require aContinue reading “FFS primary care is higher quality than DPC. “Proved.””

DPC’s narratives can be just as misleading as their quantitative studies.

Advocates for the DPC movement have many stories to tell the public about how great DPC is. Some of their most potent narratives, however, are as misleading as their slew of quantitative studies. One root cause is that DPC advocates seem unable to imagine anyone else being as clever as they are. The ur-brag ofContinue reading “DPC’s narratives can be just as misleading as their quantitative studies.”