Modeling tool · Not a recommendation
DAV Population Model

Test scorecard designs
against your population.

A modeling tool for analysts. Enter results from your own cost study to explore how cohort size, reimbursement, adherence targets and scorecard terms interact. Every arrangement is different; no rate, target or threshold here is a recommendation.

DAV levels · General reference
DAV-1
Reporting
Provider supplies patient-level adherence data. Conditions inclusion in the payer's enhanced network products.
DAV-2
Single-metric scorecard
Provider runs outreach to lift adherence from the aligned baseline. Unlocks up to the maximum budgeted rate increase.
DAV-3
Composite scorecard
Adds validated episodic disease-related cost. Unlocks above-budget increases sized within the validated return.
Modeled cohort
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Adherence
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PY1 in-window savings
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Performance year-end run-rate
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PY1: monthly savings and adherence
Disease-related non-device savings accrue as patients convert to adherent. Back-loaded ramps accrue less in-window savings than the performance year-end run-rate suggests.
Monthly savingsPopulation adherence rate
Scorecard test
Tests the scorecard terms you entered against modeled results. Terms should be set by the payer and provider from their own cost study and negotiations.
From new starts to modeled cohort
Patients already claimed by another risk model, or without continuous eligibility, are excluded so savings are not counted twice.
Can the savings fund a rate increase?
How this model calculates
    References

    This model is a prototype for general informational and educational purposes only. PraxisBlue does not prescribe rates, targets, thresholds or scorecard terms. Any example values are illustrative, not market rates or empirical findings. The adherence-to-cost relationship shown is associational and subject to the healthy-adherer confound: patients who adhere to their device may also differ in other ways that lower their costs. Results do not constitute legal, financial, actuarial, clinical, or compliance advice and are not a substitute for a payer's own claims analysis.