Frequent Case Studies Buyer? — Save more than $500 annually with our Healthcare Case Studies Membership. Click here for details.

Between Medicare's aggressive migration to value-based payment models and MACRA's 2017 Quality Payment Program rollout, healthcare providers must accept the inevitability of participation in fee-for-quality reimbursement design—as well as cultivating a grounding in health data analytics to enhance success.

As an early adopter of the Medicare Shared Savings Program (MSSP) and the largest sponsor of MSSP accountable care organizations (ACOs), Collaborative Health Systems (CHS) is uniquely positioned to advise providers on the benefits of data analytics and technology, which CHS views as a major driver in its achievements in the MSSP arena. In performance year 2014, nine of CHS's 24 MSSP ACOs generated savings and received payments of almost $27 million.

Health Analytics in Accountable Care: Leveraging Data to Transform ACO Performance and Results documents the accomplishments of CHS's 24 ACOs under the MSSP program, the crucial role of data analytics in CHS operations, and the many lessons learned as an early trailblazer in value-based care delivery.

In this 23-page resource, Elena Tkachev, director of ACO analytics, Collaborative Health Systems, describes how a robust suite of data analytics and technology supports the CHS provider community across 11 states, increasing accountability among CHS's 3,200 physicians and clinicians who serve over 280,000 traditional Medicare beneficiaries.

Ms. Tkachev offers the following insights in this report:

• The essential role of primary care as the quarterback of care, charged with improving patient experience, care quality and cost;
• The financial, clinical and quality gains of CHS' MSSP ACOs since embarking on accountable care in 2012;
• The changes and markers in the healthcare industry that providers who care for Medicare beneficiaries can't afford to ignore;
• The three main responsibilities of data analytics to support CHS providers;
• The quartet of CHS data sources and the organization's means of sharing this data across providers;
• A trio of methods to view healthcare data in order to track and monitor provider performance over time;
• Key data analytics hurdles and some solutions CHS has developed to overcome these challenges;
• Scorecards and reports generated by the CHS data analytics suite and a glimpse at recent results;
• Innovations in patient outreach that contribute to overall CHS success;
• Tailoring efforts to engage physicians in health data analytics to sophistication levels within practices;

Table of Contents

• Data Analytics in Accountable Care: Strategies and Case Studies
  • Technology and Analytics for Population Health
  • CMS, Value-Based Healthcare and MACRA
  • ACO Group Delivery Models
  • 3 Ways Data Analytics Support ACOs
  • 4 Healthcare Data Sources
  • 3 Ways to View Healthcare Data
  • 3 Data Analytics Challenges and Solutions
  • Reporting, Outreach and Results
• Q&A: Ask the Expert
  • Specifics on ACO Patient Claims Data
  • Billing ACO for DME
  • IT Platform for ACO Analytics
  • Reconciling MSSP and CMS Data Feeds
  • Proxy and Process Scores
  • Medicare Beneficiary Retention and Annual Wellness Visit
  • Engaging Physicians in Data Analytics Tools
  • Home Visits and Telehealth in the ACO
  • Help from Health Insurance Exchange
  • ACO Performance Improvement
  • Chronic Care Management Reimbursement
  • Retrospective Versus Prospective Models
• Glossary
• For More Information
• About the Contributor