Primacea Solution Case Study

In 2016 Primacea was asked to support a prominent Academic Medical Center in ensuring that the industry interactions of its 2,000+ physicians were accurately reported.

With Open Payments data available each July, it was imperative to the client that the data reported about its physicians be accurate and match with their internal and external conflict reports.

Working with the client AMC, Primacea developed a program/system where:

• Physicians could efficiently review and dispute Open Payments data in a portal that was much more intuitive and user-friendly than the difficult CMS system. This exponentially increased the review of payments by physicians, and led to substantial corrections of the record, and changes in physician practice to avoid reported conflicts. And, having seen their Open Payments report during the review period beginning April 1, physicians in the program were able to easily prepare and submit internal conflict reports that had dramatically higher synchronicity with Open Payments/Sunshine data than those filed by physicians not in the program.
• Compliance staff at the client were provided with a portal allowing them to view the industry activities of all of their 2,000+ physicians. The portal allows staff to easily sort or run reports by MD, specialty, type of payment or by pharmaceutical or device manufacturer. The portal is also used to ensure that reported conflicts match the Open Payments data.
• Results for 2016 and 2017 payments:
  • Over 300 disputes filed on behalf of MD’s
  • Major errors corrected, such as mis-categorization of payments (including a $2.4 million research payment initially mis-categorized in the “Other/Speaker” payment category), incorrect amounts, etc.
  • Dramatic increase in “synchronicity rate” between conflict reports and Open Payments data - over 75% of MD’s in the program filed conflict reports matching Open Payments data, vs. under 35% for those not in the program