Accelerating Insights in Value-Based Care

Overview

How would your clinical and financial operations improve if your team had access to claims data within days of a patient visit, instead of weeks or months?

EHR data and ADT feeds are useful in certain scenarios—but pairing longitudinal claims history with claims lagged just a few days, puts value-based care (VBC) organizations in a better position to coordinate patient care and identify early financial trends.

On May 16, CMS released an enhancement to the Beneficiary Claims Data API (BCDA), enabling access to partially adjudicated claims data within two to four days of submission. Listen to this session to learn how your peers at Pearl Health and Upstream plan to adopt this data to advance key priorities, including:

• Patient Prioritization and Care Coordination – Identify patients that are “high need”, have specific care gaps, or have recent new diagnoses. Provide physicians with data that allows them to make the most of their patient interactions.
• Financial Forecasting – Produce accurate financial trends earlier, allowing organizations more time to address any issues or make strategic changes. Understand the volume of high-cost events at the midpoint of a month to better estimate total expenditures before the month is even over.
• Adverse Event Notification – Ensure that you know the details of every emergency department visit or inpatient admission regardless of the site. Use such notifications to plan for timely follow-up and prevent downstream issues.