CMS recently threw a curve ball to BPCI Advanced participants, announcing that providers must participate in new clinical episode service line groups (CESLGs). Participants will no longer be able to select discrete episode categories; rather, they must participate in new clinical episode service line groups (CESLGs) that combine several related episode types. This may have participants in other Alternative Payment Models wondering if major changes like this are coming their way as well. We take a look at the impact of this change in our new white paper, “Evaluating Clinical Episode Service Line Groups in BPCI Advanced.” Download today for a deeper understanding about this change, and to help your organization be ready for future shifts in the value based care landscape.
Alternative payment programs are critical to payment and care delivery transformation. Yet, with new programs, amendments, and updates coming monthly, keeping ahead of which programs offer you the greatest opportunity can be a major challenge. That’s why DataGen put together this User Guide to Alternative Payment Models. Offering insights on the three major participation categories—and detail on programs within each category—this resource can help you determine the best course for your organization’s future. Download Navigating Alternate Payment Models: A User's Guide today.
As participants in Model Year 3 of the BPCI Advanced program prepare for the next model year, one thing is clear: success in the program is founded on effective data analysis. That’s what Main Line Health, a five-hospital integrated health care delivery system in Pennsylvania recently discovered. When they realized they needed data-driven help choosing the best episodes in BPCIA, they turned to DataGen. Our new case study, The Transformative Power of Effective Data Analysis in BPCIA, details how DataGen’s reports and dashboards helped drive success in the program through rigorous and customized data analysis. Take a look, and find out what prompted Main Line Health’s Manager of Clinical Integration to say, “I think I’m best friends with our data analysts now.”
SHOULD YOU STAY OR SHOULD YOU GO?
The Oncology Care Model (OCM) has undergone what may be the most significant reconciliation in its three-year history. While all participating practices have been able to limit their downside risk up to now, many practices will be forced to either take on two-sided risk or exit the program.
For these practices, now is the time to be taking stock of the ROI of the program and determine if it’s more risky to stay or go. There are five key questions practices need to ask to make a sound assessment.
Download Calculating your future risk in OCM: SHOULD YOU STAY OR SHOULD YOU GO? to read more.
The March 12 application deadline for BPCI Advanced has come and gone, and practices are waiting to get their data back from CMS. In this new article, "How to use your data analysis to get clinical buy-in," we explore the opportunity to make the most of this period. Engaging clinicians now is a great way to stay ahead of the game. When it's time to select which DRGs to participate in, your physicians will already be on board to take the next step on the BPCI Advanced journey. Read more for 8 tips on how to build engagement with physicians.
August 24, 2017
Now that the Oncology Care Model (OCM) has passed the one-year mark, participants have more experience with the program. Navigating the program effectively, however, is still a challenge for many. Thanks to data lags and OCM’s fundamental differences from other bundled payment programs, the program has a steep learning curve. Fortunately, DataGen has tips that will help providers develop strategies to achieve better outcomes in the program. “OCM: Challenges to Implementation,” provides a deep analysis of the first year of the program, plus recommendations to help you improve your performance. Download Now
February 16, 2017
The challenges and benefits of bundled payments and risk-based arrangements is one of the biggest issues facing the healthcare field. Kelly Price, DataGen’s Vice President and Chief of Healthcare Data Analytics, and Stephanie Kovalick, Chief Strategy Officer at Sage Growth Partners, sat down to help shed some light on ways to succeed with payment reform initiatives such as bundled payments and risk-based payment models. Read more about this conversation in our new installment, “The Future of Payment Reform: How can providers, patients, and payers benefit—and who bears the burden?”
October 6, 2016
The healthcare industry is in a state of quiet anticipation as we await the second data feed from the Centers for Medicare and Medicaid Services’ (CMS) Comprehensive Care for Joint Replacement (CJR) bundled payment model. Participants still have a lot of questions. Will the program help hospitals deliver better accountability for care? Will care be coordinated more effectively? Is it going to help reduce costs—and if it does, for whom? Download Now
August 1, 2016
Launched on April 1, 2016, CJR is the first mandatory bundled payment program from CMS. Affecting more than 750 hospitals in 67 markets, CJR creates a host of new challenges and opportunities for participants. Read the article to learn more about the program and prepare for the initial data release.
July 12, 2016
Announced by CMS in January 2015, the Oncology Care Model (OCM) is one of the most recent programs in a litany of new experiments. Simplifying and organizing the complex data and policy components of this program requires specialized expertise in healthcare analytics.