By Zach Bredl

What is MDPP?
Diabetes is a condition that affects more than 1 in 4 Americans age 65 and older.1 Centers for Medicare and Medicaid Services (CMS) estimated that Medicare spent $42 billion more on beneficiaries that have diabetes than it would have spent if those beneficiaries did not have diabetes. Let’s take a look at PMPY (Per Member Per Year) spend breakouts in 2018 [...]

By Amanda Forlin
Data Visualization by Cody Elias

The Centers for Medicare and Medicaid Services (CMS) released the 2018 Financial Performance results on all Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP). CMS shared this data for the last six years, contributing to a more […]

By Stacey Yue Cao
 
As of February 2018, about 30 million people (or 9.4% of the U.S. population) suffered from diabetes; another 84 million people aged 18 or above had prediabetic symptoms.¹ Diabetes is a chronic condition; proper and timely diabetes care management is critical to ensure that people with diabetes can […]

By Chris Freyder

Medicare is the federal health insurance program started in 1965 that is provided for individuals who meet certain criteria. Those who are over the age of 65, younger people who have certain disabilities, or anyone who has End-Stage Renal Disease (ESRD) qualify for Medicare insurance. In 1997 Medicare Advantage […]

By: Zach Bredl and Cody Elias

The Growing Opioid Epidemic
The opioid epidemic is a serious public health crisis that is affecting the nation’s social and economic welfare. In 2017, opioids were responsible for about 130 deaths per day, more than 47,000 yearly. Opioid prescribing rates are three times higher than they were in 1999 while opioid overdoses are an astounding five times higher. How did this happen? [...]

By Ivy Xiwen Deng Data Visualization by Sanat Malhotra

In the wake of the Affordable Care Act (ACA), hospitals have drawn attention from policymakers as key partners in reducing the overall cost of care. Consequently, the effort has led to an enhanced focus on preventing readmissions and reducing unnecessary care. The ACA implemented several policy measures to hold hospitals accountable for what happens to patients post-discharge. [...]

By Blair Ford Mohney and Sarah Grace

In the last post, we highlighted trends in the migration of beneficiaries between Medicare fee-for-service and Medicare Advantage in the United States. In doing so, we can understand why this is such a hot topic for so many of our members across various markets. […]

Listen in as Mallory Cary, ACO Operations Director of Universal Health Services (UHS), one of the nation’s largest hospital management companies, and Abbas Bader, Director of Product Development at CareJourney discuss their collaboration on building better and more optimized networks using claims data and insights from CareJourney’s Network Advantage platform.

You […]

By Sarah Grace and Blair Ford Mohney
Data Visualization by Cody Elias

CareJourney’s Network Advantage platform is largely built upon the full Medicare fee-for-service claims dataset, but it is used by members to draw insights about population health and quality of care for all Medicare enrollees. While fee-for-service and Medicare Advantage beneficiaries are […]

By Ivy Xiwen Deng

Signed into law in March of 2010, the Affordable Care Act directed the release of Medicare data to the private and public sectors for performance measurement.

Until today, we haven’t had a trusted or transparent measure of costs or outcomes for the healthcare delivery system at the physician level. […]

The past decade has seen a remarkable increase in the number of lives covered in risk-based contracts. According to a recent article by Leavitt Partners published in Health Affairs, “At the end of the first quarter of 2018, we were tracking a total of 1,011 ACOs representing 1,477 distinct active accountable care payment contracts with public and private payers. [...]

By Timmy Del Vecchio

As organizations continue the transition to value-based care, the need to (1) identify, (2) assess, and (3) eliminate wasteful spending continues to be a priority. From the identification perspective, initiatives like Choosing Wisely, started by the American Board of Internal Medicine, help both providers […]

By Edward Yurcisin

The Centers for Medicare & Medicaid Services (CMS) recently held the second annual Blue Button 2.0 Developer Conference on the 54th anniversary of Medicare. There were several key takeaways from the conference [...]

By Chris M. Lester

Community-level social determinants of health and economic distress explain some differences in health service utilization and disparities in health outcomes among Americans broadly, and perhaps especially among Medicare enrollees due to their age or disability status. […]

By Charlotte Jackson

Among people whose job it is to mine healthcare data for insights on population health and quality of care, there can be a tendency to assume that insights generated from one source of data (e.g., traditional Medicare) will naturally prove to hold true when applied globally to all patients […]

By Deepika Kumar

Listen in as Aneesh shares with CareJourney members and partners the key highlights from HIMSS 2019; covering topics such as Consumer-Directed Exchange, Bulk APIs regulations, FHIR Accelerators, and more. […]

By Ben Bigelow

The ecosystem of healthcare data is vast. There are electronic health records (EHRs), medical claims, lab results, biometrics, and a whole slew of other data sources, including open data published by organizations like the Center for Medicare and Medicaid Services (CMS). […]

By Timmy Del Vecchio, graphic by Ben Bigelow

As CMS recently made unembargoed Performance Year (PY) 2017 results available to ACOs in late August, ACOs were able to view not only PY 2017 financial expenditures relative to benchmarks, but also the ACO’s overall quality score for the performance year. For an ACO […]