Symmetry Health Data Systems Announces TRIGON Blue Cross Blue Shield Selection of Episode Treatment Groups

Strategic Insights -

TRIGON Blue Cross Blue Shield, a 1.8 million-member managed care organization, has selected Episode Treatment Groups (ETGs) from Symmetry Health Data Systems, Inc. as its episode-building, patient classification methodology. TRIGON will use ETGs for quality improvement, network management, utilization management, and reimbursement. This selection marks a significant milestone for Symmetry Health Data Systems, with TRIGON being the latest addition to its growing list of clients adopting ETGs. The episode-building patient classification system utilizes routinely collected inpatient and ambulatory claims data to identify mutually exclusive and exhaustive treatment episodes.

Key Takeaways:

  • TRIGON Blue Cross Blue Shield has selected Episode Treatment Groups (ETGs) from Symmetry Health Data Systems, Inc. for its episode-building, patient classification methodology.
  • TRIGON will utilize ETGs for quality improvement, network management, utilization management, and reimbursement.
  • ETGs are a clinically homogenous and statistically stable patient classification system developed by physicians and epidemiologists.
  • ETGs provide a firm methodological platform for severity- and casemix-adjusted comparisons, making it acceptable to both clinicians and administrators.
  • Symmetry Health Data Systems, Inc. has extensive experience in health care data analysis and has developed analytic methods that form the basis of industry standards for managed care organizations, insurance carriers, Fortune 1000 corporations, and the Federal government.
  • TRIGON Blue Cross Blue Shield is a 1.8 million-member managed care organization with operations in 42 states, the District of Columbia, and the United Kingdom.

Statistics:

  • 1.8 million: The number of members served by TRIGON Blue Cross Blue Shield.
  • 42: The number of states in which TRIGON operates, in addition to the District of Columbia and the United Kingdom.

Sources:

  • PR Newswire, 12/01/95
  • Symmetry Health Data Systems, Inc.
  • TRIGON Blue Cross Blue Shield
  • Blue Cross Blue Shield of Virginia
  • Mitchell Portnoy, Symmetry Health Data Systems, Inc. (602-840-1910, ext. 112)