Data Analytics in Accountable Care:
"No Matter What Happens, This Change is Coming"
Two aggressive milestones to migrate Medicare providers to value-based healthcare are on the horizon:
- In 2016, CMS expects 30 percent of Medicare fee-for-service (FFS) reimbursement to be tied to alternative payment models such as accountable care and bundled payments.
- Also this year, the federal payor wants 85 percent of Medicare FFS payments to be based upon quality metrics.
"If you are a provider, or working with providers who accept Medicare beneficiaries, it's really important to know these changes are coming," advises Elena Tkachev, director of ACO analytics for Collaborative Health Systems (CHS). "It will be the responsibility of physicians to participate in these payments because no matter what happens, this change is coming."
Ms. Tkachev detailed the power of data analytics to drive CHS's success in accountable care during Data Analytics in Accountable Care: Strategies and Case Studies, a January 2016 webinar from the Healthcare Intelligence Network now available for replay.
In case you missed this webinar, you still have a chance to watch this highly-rated program.
Register to view the conference today or order your training DVD or CD:
As the largest sponsor of Medicare Shared Savings Program (MSSP) ACOs in the United States, CHS has a firm handle on HHS's value-based agenda. The organization manages 24 MSSP ACOs, nine of which generated savings of nearly $27 million in 2014, and one that has been accepted as a Next Generation ACO, the newest Medicare accountable care model.
And with CMS expectations for value-based reimbursement slated to rise over the next two years, expectations for data analytics to improve care and costs related to Medicare beneficiaries have never been higher.
"Today, physicians are being measured through claims and the clinical metrics on the population they serve. We see the main responsibility of analytics as providing simple access to actionable, timely and relevant information to help clinicians make better decisions, improve quality of care and enhance the patient experience."
Despite the magnitude of its enterprise, CHS believes its future in accountable care rests upon its primary care physicians (PCPs), which it views as "quarterbacks of care" for its more than 280,000 Medicare beneficiaries.
To foster quality improvement, CHS equips PCPs with an arsenal of analytics capabilities. So that its 3,200 providers can tap into CHS's massive storehouse of CMS, claims, lab, risk stratification and care coordination data collected on its 24 MSSP ACOs, the health system recently rolled out an analytics and dashboard portal.
These tools enable providers to monitor the aggregate health of their populations as well as their own performance, even giving providers the ability to track their own performance over time and contrast it with other clinicians'—a capability that pleases CHS's more competitive physicians, Ms. Tkachev notes.
Frequent webinar training keeps provider analytics' use sharp, and dashboard-generated reports and scorecards help physicians to monitor and enhance quality performance and improve patient outreach, Ms. Tkachev explained.
Despite its significant success, CHS still encounters the perennial challenges of access to timely and accurate data, aggregation abilities, and the display of meaningful results. Ms. Tkachev shared some CHS tactics to resolve these issues, including soliciting feedback on the tools from providers who use them.
You can "attend" this program right in your office and learn about CHS' experience in using data analytics effectively to improve ACO results.
It's so convenient! Invite your staff members to watch the conference. We will send you a DVD or CD-ROM of the conference proceedings or a link to our web site with a username and password. You can log in and view the program right from your computer — any time of the day or night, whenever convenient for you and your colleagues — and benefit from the archived recording of the conference, including the Q&A period.
You'll get to listen to the question and answer session to hear: how claims data is reported to ACOs; details on the IT platform utilized for ACO analytics; how to handle reconciling for differences and calculating per member per month and utilization based on the MSSP claims feed versus the results for the quarterly CMS aggregate data; how to monitor and calculate a proxy quality and process score internally throughout the year; the impact of the annual wellness visit on beneficiary retention; and how physicians are trained to use the provider dashboard reports and other tools.
To register for the on-demand re-broadcast, download an .MP3 file or order the training DVD or CD-ROM of Data Analytics in Accountable Care: Strategies and Case Studies, please visit:
You may also be interested in these HIN resources: