Blog
A Pulse on Healthcare Insights, Trends, and Hot Topics
Tracking Unnecessary Care Through Claims-Derived Measures
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 […]
Recap of the Blue Button Developer Conference 2019
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 [...]
Microsoft Health NEXT and CareJourney Research Report: Impact of Regional Social Determinants on Health Services Utilization
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. […]
Leveraging Medicare Advantage Encounter Data for Better Practice Portraits
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 […]
CareJourney HIMSS Debrief
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. […]
ACO Open Data Report
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). […]
Turning Quality Score Insights into Actionable Opportunities
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 […]
2017 ACO Results: A Summary of What Mattered Most
By Ben Bigelow
Last week, CMS published the 2017 performance year results for the Medicare Shared Savings Program (MSSP). It comes on the heels of a new proposed rule from CMS that is meant to drive more accountable care organizations (ACOs) to take on downside risk, something few ACOs have […]
The new MSSP rule: the questions we should be asking
By Abbas Bader
As most of you are already aware, CMS released a rule proposing changes to the Medicare Shared Savings Program earlier this month. By now, you have probably read several summaries of the key provisions of the rule, if not the full 607 pages of the rule itself. In a […]
Blue Button 2.0: A convening of tech leaders, CMS and the White House
By Edward Yurcisin
As our President, Aneesh Chopra, often notes, there appears to be a “generational consensus” from leaders in Washington seeking to tap the expertise of the American people to solve big problems. This is exactly what happened on Monday August 13thwhen the White House Office of American Innovation and CMS […]
ACOs and Rural Healthcare
By Chris Lester and Sabrina Chugani
Roughly 20 percent of the United States population lives in rural areas. Despite this, rural America faces a number of health-related challenges, some of which are structural, while some are related to regional differences in health and health care in this country. Compounding these issues, incomes […]
Custom Patient Risk Groups and Interventions
By Vinith Annam
Creating Patient Risk Groups
In a previous blog post titled Harnessing Open Health Data & Methodologies to Serve Value-based Care Networks, CareJourney discussed Harvard T.H. Chan School of Public Health’s development of a publically available patient segmentation model which identifies a small percentage of Medicare beneficiaries who account for […]
Making the Case for CCM
By Deepika Kumar
Our patient segmentation model finds that for MSSP populations across the country, most patients fall into the major complex chronic illness segment (to qualify for this segment, a patient must have two or more complex conditions or at least 6 non-complex conditions) and historically most of the day-to-day […]
The Health Internet, a Decade in the Making, Gets a Shot in the Arm
By Aneesh Chopra, President and Co-Founder of CareJourney
Earlier today, at the opening ceremonies for the largest health IT conference of the year, Jared Kushner made a surprise appearance committing, unequivocally, to a “whole of government” approach to ensure patients and their caregivers can connect their health data to any application that helps […]
Benchmarking Provider Groups Using Clinically-Relevant Metrics
By Katie Poore
An ACO’s ability to communicate and measure a standard of excellence for its participating practice groups is a critical component in achieving annual shared savings and improving care quality for the beneficiaries the ACO serves. Comprehensive analytics and benchmarks with actionable takeaways are fundamental to this objective. To assist […]
ACO Winners and Losers
By Ben Bigelow
Last week, Medicare published its list of 2018 participants in the Medicare Shared Savings Program (MSSP) and the MSSP 2018 Fast Facts. Since its inception in 2012, the MSSP has grown from 220 Accountable Care Organizations (ACOs) with 3.2 million beneficiaries to 561 […]
Accountable Care Organization (ACO) 101
By Stephanie Sealy
The Affordable Care Act established several programs administered through the Centers for Medicare and Medicaid Services (CMS), the aims of which were to incentivize and partner with providers to proactively coordinate patient care, maintain and improve the quality […]
Harnessing Open Health Data & Methodologies to Serve Value-based Care Networks
In December 2016, CareJourney launched the Insights Workbook—a monthly executive-level review of ACO performance, with actionable metrics and data visualizations to get to increased savings. Our analytic model is firmly rooted in the questions population health leaders seek to answer and is driven by our members. By aggregating […]
A Guide to Fast Healthcare Interoperability Resources (FHIR)
FHIR is growing interest as the standard for easily and securely exchanging healthcare data. What is it and what does it means for healthcare providers? Below we answer some frequently asked questions: [...]
Purpose Driven Design, Health Equity, and Bring Open Data to Life
Health Experience Refactored (HxRefactored) is a revolutionary conference co-hosted by health innovation event planner Health 2.0 and design agency Mad*Pow. This year’s conference gathered more than 600 cross-disciplinary thinkers and professionals to discuss how to improve healthcare through better patient-centered design. HxRefactored applies design, science, evidence, and theory to re-imagine the […]
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