Stratasan: An Intern Experience – Chelsea Derer


Chelsea Derer, Vanderbilt Senior and Stratasan Intern (2014)

I am a senior at Vanderbilt University and recently finished a summer internship at Stratasan. In my time there I learned an incredible amount and am so appreciative of the opportunity I had to work at a wonderful company with amazing people. Advice I received prior to my internship was extremely helpful in making it such a great experience for me. After reflecting on my time at Stratasan, I’ve developed this list of my top 6 pieces of advice for interns.

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Stratasan Adds New President

Marshall MartinStratasan is excited to welcome new company president Marshall Martin to the team.  Marshall joins Stratasan having previously served as COO of Nashville based technology companies Juris and PureSafety.

“Marshall is the right addition to lead the management team and to help us accelerate Stratasan into the net phase of growth,” said Jim Phillips, chairman of Stratasan. “Marshall’s expertise driving growth and profitability in emerging companies combined with the strength of our platform and capabilities of the existing management team and staff at Stratasan provide a good match to capitalize on a very opportunistic market for the use of data and analytics to support strategic business decisions for healthcare.”

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Q & A with Marshall Martin

Tell me a little bit about your background and previous work history.

I am a graduate of The University of Tennessee at Chattanooga with a BS in Accounting.  I served as Corporate Controller for Olan Mills Portrait Studios and VP/General Manager for US Express Dedicated Services.  I served as COO for Juris Software, and most recently, Pure Safety, both of which were high-growth software companies.

How would you describe yourself?

I am a high-energy, highly motivated, extroverted business leader, athlete, and coach.  I am a Christian, loving father, and trusted friend.

How do you define success?

Success is the result of doing the right things the right way.  It is a result of the right behaviors, and you cannot forces success.  For me, success is being a part of others achieving things they may have otherwise not believed they could have on their own.  

What are you passionate about?

A shorter list would certainly be, “What are you not passionate about?”  I am passionate before the alarm goes off!

Why choose Stratasan, and what do you see in Stratasan’s future?

Stratasan has an awesome team and an awesome product in a hot market space.  I see our company capturing leading market share while serving those with critical information to make a difference in the lives they serve.  It is truly about “a business for a higher calling”.

What challenges can be expected in your new role?

Being able to keep up with rapid growth and great opportunities. You cannot do everything everyday, so you have to be wise about what you want to tackle on any given day. FOCUS!

What do you want Stratasan’s current and potential customers to know about the company and the direction it is headed into?

Stratasan is a company on the move.  Our technology and expertise make the process of using data for decisions a user-friendly process with laser-focused results.  

Full story on Martin can be read here.


Medicare Provider Utilization and Payment Data: Physician and Other Suppliers

Last week when CMS released the public data set, the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (PUPD for short), most of the articles primarily focused on the top ten physicians with the highest charges.  The focus was on sensationalism and in general missed the main point of this data.

Below are some examples of headlines regarding the release of the data:

“Sliver of Medicare Doctors Get Big Share of Payouts” (New York Times, April 8)

“Doctors’ Medicare Pay Revealed” (USA Today, April 8)

“Data Uncover Nation’s Top Billers” (Washington Post, April 8)

“Looking Under the Hood of Medicare (USA Today, April 9)

“Medicare Pulls Back the Curtains on How Much it Pays Doctors” (NPR, April 9)

” The Top 10 Medicare Billers Explain Why They Charged $121M in one Year” (Washington Post, April 9)

“Seven Doctors got more than $10M each from Medicare in 2012” (USA Today April 10)

“Find Out How Much Your Doctor Makes from Medicare” (Cleveland Plain Dealer, April 10)

“What Doctors Make from Medicare’ (Bloomberg Business Week, April 14)

Although these articles may have mentioned some other points, they primarily focused on the “top billers”.  We, at Stratasan, have downloaded the data and analyzed it a little differently.  Below are the top ten Healthcare Common Procedure Coding System (HCPCS) codes in volume in the file.

Physicians who saw one million visits for an office or outpatient visit with an established received on average $54.92 for that visit.  These top ten codes represent 4.3% of the total codes in the database.  The physicians received on average $244 per visit.

PUPD table top HCPCS

We are analyzing the data from a market perspective for customers.  We’re analyzing the top physician office visit codes for physicians in their service area giving them insight into what is being seen in their community’s physician’s offices.

Below are the fields in the data:

  • NPI number
  • Provider Last Name or Organization Last Name
  • Provider First Name
  • Provider Middle Initial
  • Provider Credentials
  • Provider Gender
  • Entity Code (Individual or Organization)
  • Provider Street Address
  • Provider Street Address, second line
  • Provider City
  • Provider ZIP Code
  • Provider State
  • Provider Country
  • Provider Type (Specialty)
  • Medicare Participation Indicator
  • Place of Service (facility or non-facility)
  • HCPCS code
  • HCPCS description
  • Number of services provided
  • Number of distinct Medicare beneficiaries receiving the service
  • Number of distinct Medicare beneficiary/per day services
  • Average Medicare Allowed Amount
  • Standard Deviation of Medicare Allowed Amount
  • Average Submitted Charge Amount
  • Standard Deviation of Submitted Charge Amount
  • Average Medicare Payment Amount
  • Standard Deviation of Medicare Payment Amount

If your organization interested in reports based on this data, please give us a call at 866-628-5051.

94% of Social Media Users Agree to Share Health Data

An interesting discussion paper was recently released by IOM’s Evidence Communication Innovation Collaborative. Below are the key findings listed in the paper and a link to download the full paper.

How will survey results like these affect HIPAA guidelines? Is the patient’s opinion taken into consideration in policy? Should there be an “opt-in” function at the individual level?

Download Full Report Here

Sharing for care improvement: 94 percent of American social media users agree with sharing their
health data to help doctors improve care.

  • With appropriate anonymity, 94 percent of American social media users with a medical condition would be willing to share their health data to help doctors improve care. The same proportion (94 percent) would be willing to do this to help other patients like them.

Sharing for better evidence: 92 percent of American social media users with a medical condition agree
with sharing their health data to help research.

  • 92 percent of American social media users with a medical condition would be willing to anonymously share health data for researchers to learn more about their disease. 84 percent would be willing to share such information with drug companies to help them make safer products, and 78 percent would do so to let drug companies learn more about their disease.

Sharing to help others: 94 percent of American social media users agree with sharing their health data
to help patients like themselves.

  • 94 percent of American social media users believe that their health data should be used to improve the care of future patients who may have the same or similar condition.

Desire to share outweighs open questions: 76 percent of American social media users worry that health data they share may be used in detrimental ways.

  • 76 percent of American social media users with a medical condition believe that data from their personal health records potentially could be used without their knowledge. 72 percent believe their data could be used to deny them health care benefits, and 66 percent believe it could be used to deny them job opportunities.

Young Invincibles Are No-Show for the Party

Based on the HHS’s self reported data on people who actually signed up for the Marketplace, the Young Invincibles (8.8%) did not show up to the party.  Comparing the actual age segments of the population from 2000 to 2012 shows just how quickly our population is aging and straining the Healthcare system already.  The current Marketplace is an inverted pyramid which translates into a very scary fulcrum to keep the balance intact.  The theory of population health management states that if we can get enough young healthy people in the base of the pyramid, it will support the demands of the more senior population.

When we looked at the Marketplace’s new age data released today and it became obvious to us that the plans can not sustain this much “greying” in their membership and still make money.

What do you think are potential solutions to this problem?

The next big shocker will of course be that the uninsured haven’t signed up. We should get this data by February. Stay Tuned.

Can your Smart Phone Manage Chronic Diseases?

The Pew Foundation put out a very interesting study last week on Chronic Diseases. It was of interest due to the numbers of people who report living with Chronic Diseases and how they are using the Internet to help manage their own personal care. In this ever increasing world of eHealth, the need for apps to manage Chronic Diseases is increasing at a rapid rate. Pew estimates there are now 45% of American Adults living with 1 or more Chronic Diseases.

The growth in mobile apps for managing care is only surpassed by those people reporting Fair/Poor Health (15% to 19% from 2012 to 2013). The number of people reporting Chronic Diseases remained consistent.

In our own research based on the National Health Interview Survey, we found 23.2% of the people living in the US with a disease that caused some limitation. This seems to validate the 24% number as reported by the Pew Report.

Both our own research and Pew confirm the linkage of Chronic Disease with age, race, education, and poverty. In addition, our own Chief Medical Officer, Dr. Stephanie Bailey estimates that about 50% of disease prevention can be related to lifestyle choices.
Not surprising was the increased utilization of health care services by those who suffer from Chronic Disease. Reports have ranged from 8-18% of the population consumes 80% of the total cost of healthcare. The Pew Study shows a strong correlation between having a significant medical event in the past year and the number of chronic diseases the patient suffers from.

Sources of Information

Having lived through the first and second waves of eHealth, one would suggest the mobile platform may be our biggest area of opportunity as a result of this study. It also points to the fact that governments, non-profits, payers, and healthcare providers all have incentives to get smart phones in the hands of those who suffer from Chronic Diseases. Those with Chronic Disease need to be under the direct supervision of a physician. Although the study does show the relationship, it is also apparent that the consumer is taking matters into their own hands (19%). This bifurcation of the traditional information provider to something new opens multiple avenues for communication.

In a recent McKinsey interview with Richard Bracken, Chairman and CEO of HCA, he stated ”Our research tells us the consumer is taking a growing and more meaningful interest in the details of his or her care, and that trend is expected to intensify. Generally, the more information we can put at an individual’s disposal—such as condition, treatment, history, cost, options and prognosis—the more effective the patient relationship could be.”

It also represents the biggest areas of opportunities for new companies to come in and re-shape the health content delivery model.
65% that use family and friends are most likely using old fashioned “social networking” at family gatherings and then Facebook/Twitter applications to get feedback on their diseases from their extended family.

There are some interesting companies in the space including Jeff Arnold’s Sharecare. The results bode well for these types of enterprises. In Nashville, another notable is Healthways who is taking an innovative approach to managing Chronic Diseases.

Medicare Use Rate Trends by State

Recently there have been many concerns regarding the use rate decline of inpatient discharges. In this post we will discuss where and by how much Medicare inpatient use rates are declining across the United States.

From 2010 – 2012 the use rate for Medicare inpatient discharges in the United States has declined 4.46%. The map below shows a percent change of Medicare use rates by state from 2010 – 2012. States with a use rate declining faster than the United States are blue, and states not declining as fast are green. The further a state’s rate of decline is from the U.S. average, the darker the color will be on the map.

Use rates in this post are calculated for Medicare inpatient discharges per thousand people ages 65 and over. The source is the Medicare Provider Analysis and Review file for 2010, 2011, and 2012.



Click the map to see all use rate data by state

The use rate in states like Montana, Maryland, and Oklahoma is dropping at almost twice the rate of the United States. Whereas in states such as Utah, Vermont, and Idaho the use rates have remained fairly consistent over three years. The next question we would ask is “why are use rates dropping?” Is it caused by a decline in discharges or an increase in population?

Medicare use rates

When we look at the United States as a whole, there was a slight increase of Medicare discharges from 2010 – 2012. But not enough to keep pace with the growth of the population over three years.

We conclude that the use rate decline is not due to decreasing discharges, but to an increasing population that uses less inpatient care. But are patients avoiding care all together, or are they seeking new alternatives in the market? Stay tuned for a post analyzing outpatient visits.

Poverty and Health Insurance Update

An important report was released this week just in time for the Marketplace/Health Insurance Exchanges starting October.  Yes that is in only 6 days.  It is here after nearly two years of intensive studying and modeling almost every possible scenario.

“We are pleased to announce the release of the 2012 American Community Survey (ACS) 1-Year statistics, the most relied-on source for up-to-date social, economic, and housing information every year,” said American Community Survey Office.  “The statistics are available for the nation, all 50 states, the District of Columbia, Puerto Rico, every congressional district, every metropolitan area, and all counties and places with populations of 65,000 or more.”

The report out today has the latest estimates on insurance coverage and poverty estimates.  For the first time in several years, the percent of poverty did not increase from 2011 to 2012.  However, when reviewing the poverty over the past decade, the percent of people living in poverty has increased to 12.2 to 15.9 percent.  Mississippi (24.2%) and New Mexico (20.8%) lead the country with the highest percentages of poverty.  New Hampshire (10.0%) and Alaska (10.1%) have the lowest poverty in the country.

The resulting increase in poverty has paralleled the decrease in Private Health Insurance and increase in Public Health Insurance.  Only 62.2% have private health insurance today among the population under 65.  The number of uninsured under age 65 has decreased to 16.9%, while Public Health Insurance has increased to 20.9%.  New Mexico, Mississippi, and Florida are low points of 50.5%, 52.0%, and 54.9% respectively for private health insurance.  In total 85.2% of the population have health insurance in one form or another.

Surprisingly, the Washington DC CBSA has only 13.1% of the population with public health insurance.  Riverside/San Bernardino has the highest public health insurance at 24.8%.

2012 United States Health Insurance and Poverty Total Population

Poverty                    49,114,537 (15.9%)
Private Health Ins.      201,091,595 (62.5%)
Public Health Ins.          96,066,799 (31.1%)
Uninsured                   45,716,676 (14.8%)

Source: 2013 American Community Survey

If you would like a poverty and insurance estimate report for your service area, please contact us today.

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