KaMMCO: Breaking New Ground in Healthcare Informatics and Quality Reporting

Volume: 2017

Issue: 12

Date: 12/1/2017

“KaMMCO announces partnerships with medical societies in Georgia, South Carolina, Connecticut, New Jersey, Missouri, and Louisiana, to bring electronic health record interoperability and advanced data analytics to physicians and hospitals.”

“KaMMCO, breaking new ground, announces receipt of the National Committee for Quality Assurance (NCQA) certification for 21 Electronic Clinical Quality Measures (eCQM) for 2017.”

Recent headlines like these, in a variety of national publications, have captured the attention of healthcare informatics professionals, and also of physicians and hospitals across the country. While physicians and hospitals in Kansas continue to think of KaMMCO as their trusted source of medical professional liability insurance, KaMMCO has not so quietly transformed itself into a company of national significance in the field of healthcare interoperability and informatics, as well as continuing to be that trusted source for physicians and hospitals in Kansas.

How has KaMMCO accomplished its transition, from a mutual medical professional liability (MPL) insurance company in Kansas, into a company that is breaking new ground in the field of healthcare informatics and quality reporting?

As a leader of a physician clinic or hospital, you have no doubt asked yourself how you can manage to evolve your organization to meet the challenges of a rapidly changing healthcare delivery market. In fact, every aspect of the traditional healthcare delivery model is being challenged, from defined quality metrics which must be reported to CMS to how providers will be paid. The ability to thrive, or even survive in this evolving model of healthcare delivery will be challenged in ways it never has been before.

KaMMCO engaged in the same sort of soul searching a few years ago, when it became apparent that, in light of the conditions in the MPL insurance market, an adjustment in our course was required. KaMMCO had been formed in response to a crisis. So, what happens when the crisis has faded, when the model of healthcare delivery is changing so profoundly that physicians and other healthcare professionals’ chief concern is the new quality reporting and pay for performance system being adopted in this country, and not MPL?

Policy Decisions
So what did we do?  It was a familiar drill: Research. Analyze. Evaluate assets. Assess risks.  KaMMCO employed the principles that have served us well over the years in making policy decisions, only this time it was done in relationship to our own business model. We began the process of determining how best to achieve our transition with a fundamental question, “Why do we exist?” In the early days, the KaMMCO founding Chairman, Dr. Jimmie Gleason, was fond of reminding us, “KaMMCO is an advocacy organization which just happens to sell insurance.” His point here was that KaMMCO is more than just an insurance company. As it turns out, Dr. Gleason’s vision of KaMMCO’s identity was right on target, and it is one we have continued to strive for over the years; now, it serves as a guiding light as we look to the future.

KaMMCO possesses many of the essential attributes for success: a sound capital position, strong and trusted relationships with its insureds, a well-organized and efficiently operated organizational structure, and a committed and talented staff. KaMMCO is also fortunate to have built a strong relationship with the Kansas Medical Society and Kansas Hospital Association, with whom we had partnered on various projects over the years, including a health information exchange (Kansas Health Information Network) and a quality collaborative (Kansas Healthcare Collaborative).

KaMMCO is not, however, a regional or national insurance company, or large enough to grow into a national carrier through the acquisition of other insurance companies. Our path forward seemed to be framed by the attributes we already possess, the most important of which is our firm belief that we are an advocacy organization ready to advocate on behalf of physicians and other healthcare professionals in the areas that were of greatest concern to them. Therefore, our company’s path follows that of the evolution in healthcare, in recent years, from volume to value.

New Business Model
KaMMCO’s plan has been fairly simple: take what we have learned as a successful physician-led organization, combined with our involvement in the health information exchange and quality collaborative in our state, apply a portion of our capital and infrastructure, and convert it into a business that physicians and hospitals need, in order to transition from a volume- to a value-based healthcare system.

As a result, two new subsidiaries were formed. KaMMCO Health Solutions was created to provide the technology and “know-how” to build electronic health record interoperability, data warehousing, and useful analytics tools for physicians and hospitals both inside and outside Kansas.

KaMMCO Casualty Company was formed to offer insurance products to these new relationships built with physicians and hospitals, in instances where it made sense. While KaMMCO’s plan seemed clear and straightforward, executing the plan has been anything but simple. KaMMCO simultaneously became both an established MPL insurance company and a technology start-up, with all of the attendant struggles that start-up companies experience. The result of beginning to execute our plan has been the reformation of KaMMCO from a single-state, single-line MPL insurance company into a national healthcare company that assists healthcare professionals in managing the risk of delivering healthcare, by providing “best-in-class” tools designed and delivered by a provider-governed organization.

KaMMCO’s introspection and hard work are beginning to pay dividends, in the way of partnerships with the medical societies of Georgia, South Carolina, Connecticut, New Jersey, Missouri, and Louisiana, in addition to our home state of Kansas. By involving actual practicing physicians and hospital professionals in the development of our analytics tools, KaMMCO’s analytics dashboards are being recognized for their ability to take clinical data and convert it into actionable intelligence, which is easily consumable by clinicians. Because the analytics utilize clinical records and are focused on the care received by the patient, regardless of where they received the care, we are able to put the patient at the center of the questions regarding quality.

As one nationally recognized quality expert put it, “You are answering questions concerning data and quality, which most people have not yet begun to ask.” Delivering quality care, in an efficient manner that provides a high level of satisfaction for both patient and provider, is also optimal risk management for any organization writing MPL, whether it is KaMMCO or another PIAA company. KaMMCO’s efforts in this area are a natural extension of our physician advocacy roots; we just had to change our business model for it to happen.

KaMMCO is at the beginning of a long journey to reimagine itself. Because the company is provider-led and we put patient care at the center of everything we do, we have become more than just an insurance company. But then, it seems, we always have been.

By Kurt Scott, CEO and President