CMS has announced revised dates for the applications for Models 2-4 of the Medicare Bundled Payment Initiative. These applications are now due on April 30, 2012. For applicants who have requested the Medicare claims data, those requests are now scheduled to be filled by February 28, 2012.
Obviously CMS is receiving a considerable number of applications for this program, and needs additional time to prepare the data that was requested by applicants. But this timeframe still only leaves applicants with 2 months to analyze the data that will be provided. The 7 data sets to be provided are extremely large (more than 1,500 columns wide; tens of thousands of records long) and require significant effort simply to load into a database system large enough to accommodate them. Once loaded, episodes of care must be constructed to include all of the services provided from admission through the end of the episode (between 30 and 90 days post-discharge). In addition, readmissions must be identified and included in the episode bundles. These steps must be completed before any analysis can begin.
Analytics for this data include selection of DRGs as candidates for bundled payment and drilling down into the DRG data to view costs by provider, provider type or medical specialty, time of occurrence, HCPCS code and other variables to determine the current costs associated with each episode type. These analyses are then reviewed by the physicians and other patient managers for opportunities for cost savings, which then become care plans for patients in these DRGs. The care plans are then simulated to determine their effect on cost, from which the bundled payment budget is established. Additional information about hospital costs, and particularly costs within other health system, can be determined from this data, and in particular the hospital revenue code detail provided in the inpatient files.
Singletrack Analytics has significant experience with this data and is working with several healthcare organizations to develop meaningful analytical approaches and tools to facilitate these processes. For more information visit our website or email info@singletrackanalytics.com.