Portugal Chooses Verisk Health for Healthcare Budgeting and Risk Adjustment Initiative

Becomes the fifth European Union government to adopt Verisk Health’s risk adjustment methodology

WALTHAM, Mass., February 22, 2010 — Verisk Health, Inc., announced today that Portugal’s Central Administration of the Health System (Administração Central do Sistema de Saúde) (ACSS) has selected Verisk Health’s consulting services to evaluate the use of risk adjustment methodologies for allocating funding to the country’s five regional health administrations (Administrações Regionais de Saúde). Verisk Health is a global leader in identifying, analyzing, and predicting healthcare risk. ACSS is an administrative central agency of Portugal’s National Health Service (NHS).

Portugal introduced diagnosis-related groups (DRGs) in 1984, the first European country to do so for hospital production management and financing. ACSS is starting a new project for the introduction of an individual-based classification system in primary healthcare. Aligned with primary healthcare provision reform — a key strategy for NHS economic sustainability and quality in Portugal — resource allocations will become more equitable and in accordance with population health needs. Understanding and integrating risk adjustment models based on individual health status will enable the ACSS to predict healthcare risk and cost accurately, promote comprehensive healthcare planning, enable a more efficient contracting process with providers, and ultimately provide more adequate healthcare provisions.

As part of the analytics consulting agreement, Verisk Health will analyze existing NHS pharmaceutical data, as well as diagnosis data, for one of the country’s regional health administrations (RHA). Through this analysis, Verisk Health will evaluate the possibility of introducing risk adjustment into the Portuguese health system. Implementation of such methodology would provide ACSS with the necessary knowledge it needs to allocate funding efficiently and rationalize overall healthcare spending.

“Improving healthcare financing requires a deep understanding of a population’s underlying risk and an accurate forecast of future costs,” said Mike Coyne, executive vice president of Verisk Health. “We are at the forefront of global healthcare reform and our solutions provide governments the invaluable knowledge they need to make sound decisions when budgeting, forecasting, and paying for healthcare.”

Risk adjustment and predictive modeling solutions provided by Verisk Health enable risk-bearing entities to analyze, predict, and manage healthcare spending. Although developed in the United States, the methodology has proven adaptable in international environments, including Europe, South America, and the Middle East. Common uses of the solutions include:

  • assessing the illness burden of individuals, groups, and populations
  • developing risk-based provider payment systems
  • forecasting population cost
  • informing care management strategies
  • allocating funding appropriately

About Verisk Health
Verisk Health, a subsidiary of Verisk Analytics, leverages healthcare data to help businesses and governments understand their medical and financial risk for the purpose of managing costs and clinical outcomes more effectively. Through the combination of leading predictive science, the finest evidence-based clinical engine, and superior technology, we have created the most extensive independent risk assessment and decision analytics platform in the healthcare industry. Our primary focus is to identify actionable strategies for managing healthcare costs and quality at both the individual and population levels. We consistently research, evaluate, and invest in our business to ensure that we remain leaders in our industry and the most efficient and effective solution for our clients. For more information, please visit www.veriskhealth.com.

About ACSS
The Administração Central do Sistema de Saúde (ACSS) is in charge of the management of financial and human resources, facilities and equipment, systems and information technology (IT) of the National Health Service of Portugal. It is also responsible for the definition of policy, regulation and planning of health financing, along with the RHAs, namely in the area of health service contracting. For more information, please visit www.acss.min-saude.pt.

Release: Immediate

Trish Tarantino (Verisk Health)

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