Episode Analysis, Selection Key to Earning Additional Medicare Payments via BPCI-A
Does your organization participate in BPCI-Advanced (BPCI-A), or has your organization submitted an application to participate in the program? If so, three years of historical claims data from the Centers for Medicare & Medicaid Services (CMS) is likely heading your way. The data can be used to help your organization determine its participation in some of the 35 clinical episodes (31 inpatient and four outpatient). BPCI-A is a risk-based program through which financial performance can be significantly influenced based on the selection of the correct episode; participants may earn additional payments from Medicare, though they could owe money back to Medicare if costs are higher than expected. Sg2/Vizient (a VHHA Shared Services endorsed business partner) can help organizations work through voluminous, and potentially confusing, amounts of data they receive and provide them with key analyses designed to help inform episode selections. The analytics and consulting teams at Sg2/Vizient have decades of experience analyzing Medicare claims data. That includes analyses conducted for hundreds of clients participating in the legacy BPCI program and BPCI-A. Please contact Glen Hall at ghall@sg2.com or (847) 779-5431 with questions about the capabilities of Sg2/Vizient.