Accountable Care Organizations (ACOs) and the Centers for Medicare & Medicaid Services (CMS) used Hierarchical Condition Categories (HCCs) for many years. With the increased participation of providers in advanced payment models, ACO leaders now require innovative analytics on HCC prevalence among the Medicare Fee-for-Service population. [...]
Quality measures are standards to evaluate performance against when caring for patients. Different measures account for different perspectives depending on the data source and sponsoring organization. They are used to not only benchmark individual clinicians and distribute bonus payments [...]
Analytics and reporting tools can help providers that participate in Alternative Payment Models (APMs) measure the pulse of their program performance and provide helpful insights into their population health and risk levels, as well as uncover the potential for lowering cost and improving care quality. [...]
Care transitions that involve moving from one health care provider to another can often be stressful and daunting for patients; looking for high-quality follow-up care while trying to manage costs can be complex. This process is equally cumbersome for nurses and care coordinators who want to ensure that they send their patients to the best in-network providers.
With 100% access to CMS’ Medicare claims dataset, CareJourney did an exploratory analysis on relevant claims to understand COVID-19 vaccination coverage. We want to answer the following questions: Who is getting vaccinated? Where are people getting vaccinated? By whom? How does vaccine penetration vary in different geographies? What is the vaccine volume breakdown for Medicare Advantage payers?
The Medicare Shared Savings Program (MSSP) is the largest value-based care program from the Center for Medicare & Medicaid Services (CMS) to date. As of 2020, there were 513 ACOs participating in the program, with a total shared savings of $2.28 billion.
As plans prepare for Open Enrollment (OE), it’s critical to understand what beneficiaries need as these Medicare Advantage (MA) plans look to recruit new and retain existing beneficiaries. It’s also critical for plans to understand historical data in specific regions to make appropriate expansion decisions.
Profiling ACO Success: What Drives High Performance in the Medicare Shared Savings Program? By Amanda Forlin ACO Data Visualization by Ivy Deng Get Access [...]
Quantifying Regional Differences in Ambulance-Sourced Avoidable ED Rates: Assessing Key Markets for the ET3 Model By Timmy Del Vecchio Data Analysis and Visualization by Stacey Cao and Ivy [...]
CareJourney and Altarum have partnered in developing a breakthrough approach in measuring care for patients with physical and cognitive disabilities, focusing on adults aged 65 and older. In our analysis of 2018 medicare FFS claims data, we identified 6.7 million traditional Medicare patients who required long-term services and supports (LTSS) and had assessments that document these conditions. [...]