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Quest Builds Value-Based Care Services With MedXM Acquisition


NEW YORK (360Dx) – Quest Diagnostics' acquisition of Mobile Medical Examination Service (MedXM) earlier this year boosts the company's efforts to support insurers and physicians in their move to value-based care, according to Quest.

MedXM provides home health services that are designed to help insurers provide proactive healthcare to members who may be at risk for disease and who have not been regularly visiting physicians on their own, Quest executives said.

Patients identified by insurers as being at risk for diabetes, for example, are contacted by MedXM to schedule health risk assessments, Quest Chairman, President and CEO Steve Rusckowski explained during the company's first quarter conference call. During the home health risk assessment, a series of tests are performed including capturing a retinal image as part of diabetic eye screening.

"This program helps identify people at risk of diabetes, and it enables health plans to improve their quality scores," Rusckowski said.

The business is part of Quest's strategy of providing extended care services, which Quest defines as extending payors' and physicians' reach outside the traditional confines of physician offices, according to Dan Haemmerle, general manager of extended care at Quest.

"Extended care is about how we can provide more value to our physicians and our payors as they are getting into value-based care arrangements. It's thinking about how to deliver more personalized medicine and also thinking about how to manage populations more effectively," Haemmerle said.

MedXM typically works with health plans to close gaps in care for patients who are not actively engaged in the healthcare system, according to Haemmerle.

"The payor will typically share some information with us about a patient they don't know much about. For many of them it's about developing that baseline of information," he said.

The goal is to collect information for the provider that will help transition the patient toward proactive, scheduled healthcare appointments rather than unplanned costly emergency room care when they might be more critically ill, according to Haemmerle.

"Our providers will sit with that patient to create a baseline and document both clinical and non-clinical information to build a full picture of the member's disease state," he said. "The provider will also be identifying obstacles to engaging with the system so that we can give the health plan a better picture of how they can work to get the patient back involved in the healthcare system."

The patients that MedXM visits are typically identified by the company's health plan customers, Haemmerle said, but he noted that one of the ways Quest can help support the business is through providing population health insights from its own databases.

"We are looking to create new value by leveraging all that Quest has to offer," he said. "We have additional capabilities with our vast data analytics and insights."

The MedXM model is an example of "operationalizing" population health intelligence, according to David Nash, Dean of the Jefferson College of Population Health at Thomas Jefferson University.

"Everybody wins. The patient gets better care, costs are reduced, and there are better outcomes at lower cost. We call that value," he said.

The model is an example of the types of strategies that are emerging from the shift in healthcare to value-based payment, according to Nash.

"You have to have the economic incentives aligned to make this make sense," he said. "In a private practice, fee-for service world, the more we do, the more we get paid. In a world of bundled payment, value-based payment, and capitation, aligning incentives drives a different kind of behavior."

Population heath strategies designed to deliver value-based care are currently being pursued by all major insurers, he added. "They know that their future depends of moving the game from volume to value."

The majority of MedXM patients are Medicare Advantage or managed Medicaid patients, but members of commercial lines or Affordable Care Act exchange lines receive services as well, according to Haemmerle. Most of MedXM's customers are health plans but the company also works with some Accountable Care Organizations, he said.

Some of the ways that Quest can further support MedXM is through its extensive menu of laboratory test offerings, but the company also hopes it can use some of its technology resources to help insurers streamline communication and engage with patients more effectively, according to Haemmerle. The company's MyQuest patient portal enables patients to log in to access test results, he noted. In addition, Quest's Quanum suite, which enables care givers to access patient lab results, demographics, health trends, and other data, can help MedXM customers have a more detailed picture of patient health.

MedXM also fits with Quest's emphasis on providing consumer-friendly access to diagnostic services. While it currently offers health assessments in the home, Rusckowski suggested that patients could at some point also use nearby Quest or Walmart locations for health screening if that were preferable.

In addition, Quest hopes to expand MedXM's services to more health plans, according to Haemmerle.

"MedXM has worked with a number of regional and national health plans, but certainly Quest works with nearly every health plan. We hope to be able to leverage some of the relationships on the Quest side of the house to make some introductions and build on the value that we are delivering to payors," he said.