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W W W. M A I N E B I Z . B I Z 25 S E P T E M B E R 1 9 , 2 0 1 6 H E A L T H C A R E & W E L L N E S S F O C U S rapidly evolving space, and if he wanted to be a major national player he needed to raise money," says Burns. "He always viewed this as a national business." He adds that Mingle already is one of the largest such service providers in the country, competing with big companies like CECity of Homestead, Pa. While Mingle Analytics pulled in 5,000 provider cli- ents in its second year of business, it is now up to 32,000. e majority of physicians in Maine have to deal with Medicare, Mingle notes, because of the per- centage of the state's population using the insurance and the fast-aging population. According to the Kaiser Family Foundation, Maine had 306,420 of the total 55,504,005 Medicare benefi ciaries in the United States in 2015. at's 23% of the state's total population, the highest of any U.S. state — tied with West Virginia. ere's been a steady rise in Medicare users in the state from 271,626 (20% of the population) in 2011. How it works Mingle says there are a large number of items to focus on in health care delivery that make a diff er- ence in quality of care. In the case of Medicare Part B, that includes giving anyone over six months old a fl u shot, prescribing an aspirin a day for someone with heart disease or the standard A1C hemoglobin test for a diabetic, he says. "Every potential intervention has a set of criteria that describes who qualifi es for a medication and then who got the medication," Mingle says. " e Medicare system measures a provider's quality of health care, not the patient's compliance with it." 1 Credit approval required. 2 Some services may require credit approval. 3 Insurance available through People's United Insurance Agency, a subsidiary of People's United Bank, N.A. Insurance products are not deposits or other obligations of, and are not guaranteed by People's United Bank or its affiliates; are not insured by the FDIC, by any other government agency, or by People's United Bank or its affiliates; may involve risk, including possible loss of principal. Financial know-how for the healthcare industry. peoples.com/healthcare FINANCING 1 • TREASURY MANAGEMENT 2 • INSURANCE 3 • PERSONAL BANKING ©2016 People's United Bank, N.A. | Member FDIC | Equal Housing Lender Overseeing the growth and operation of a healthcare organization requires vision and planning. At People's United Bank, we offer products and services that are well-suited to the unique needs of the healthcare industry. A lot of doctor's practices are not generating data that Medicare A lot of doctor's practices are not generating data that Medicare A lot of doctor's practices are not generating data that Medicare A lot of doctor's practices are not generating data that Medicare A lot of doctor's practices are not generating data that Medicare A lot of doctor's practices are not generating data that Medicare A lot of doctor's practices are not generating data that Medicare A lot of doctor's practices are not generating data that Medicare A lot of doctor's practices are not generating data that Medicare A lot of doctor's practices are not generating data that Medicare A lot of doctor's practices are not generating data that Medicare A lot of doctor's practices are not generating data that Medicare A lot of doctor's practices are not generating data that Medicare A lot of doctor's practices are not generating data that Medicare wants or in the form Medicare wants. Mingle can help with what wants or in the form Medicare wants. Mingle can help with what wants or in the form Medicare wants. Mingle can help with what wants or in the form Medicare wants. Mingle can help with what wants or in the form Medicare wants. Mingle can help with what wants or in the form Medicare wants. Mingle can help with what wants or in the form Medicare wants. Mingle can help with what wants or in the form Medicare wants. Mingle can help with what wants or in the form Medicare wants. Mingle can help with what wants or in the form Medicare wants. Mingle can help with what wants or in the form Medicare wants. Mingle can help with what wants or in the form Medicare wants. Mingle can help with what wants or in the form Medicare wants. Mingle can help with what metrics the doctors should report on, which are the best to use. — John Burns, Maine Venture Fund Medicare has the largest, most aggressive pro- gram for measuring such medical interventions, he says. It was introduced in 2007. It arose partly because the World Health Organization found the cost of health care per person in the United States was almost double per person annually compared to elsewhere in the world, yet the quality of care fell close to the bottom compared to other countries. "Since the 1960s and 1970s health care infl ation has exceeded all other infl ation," Mingle says. "So the primary goal [with Medicare] isn't the measurement. e primary goal is to adjust the incentive. It had been fee-for service, quantity. Medicare is attempt- ing to move us to a value-based purchasing system by paying better for high-quality, low-cost care." e fi rst step was the Physician Quality Reporting Initiative in 2007, then the Physician Quality Reporting System in 2012, encouraging providers to send in data. In 2013 Medicare imposed a 1% penalty on allowable charges for those who didn't send in data, and that's now 6%. Medicare publishes 200-300 measures from which practitioners could choose up to nine interventions, so they can make the most of the quality for the needs of each patient, Mingle says. "A lot of doctor's practices are not generating data that Medicare wants or in the form Medicare wants," says Maine Venture Fund's Burns. "Mingle can help with what metrics the doctors should report on, which are the best to use." e new MIPS rule will be fi nalized in November. It will take eff ect Jan. 1, 2017, and the fi rst reporting under it will take eff ect March 31, 2018, giving provid- ers a chance to update their systems. It's within that updating that Mingle sees opportunity both in con- sulting with the providers about their own systems and subsequently using its own software to prepare their Medicare submissions. Adds Burns, "I like the macrothesis [for invest- ment]. Health care reform in the United States will continue for the rest of our lifetime. Good reporting from medical providers is a key part of that." L V, Mainebiz senior writer, can be reached a t @ . a n d @ LV

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