Digging into the Data: CMS has identified specialists and treatment of chronic conditions as part of their new Strategic Vision for coordinating care toward value. So let’s look at the chart below of a rheumatology group in Nashville, using the Franklin:BI business intelligence platform. It reveals that different specialists within this group treat rheumatology cases differently.
This chart allows you to view respective specialist cost per beneficiary from that practice alone – charges, payments, volumes – available down to the HCPCS code-level.
Understanding practice preferences, the risk score of the patient panel, and the choices within a single group practice are all means to better understand longitudinal episode costs and modalities of treatments.
This type of reporting could help your group:
- Avoid chronic conditions and the episodes they create (using physician panel demographics to reveal chronic case loads)
- Analyze underserved populations and see where to expand your services
- Show improving quality of care and outcomes for all practitioners (by tracking MIPS and PBPY costs)
- Capture your ACO’s Benchmark Adjustment for serving a higher proportion of the underserved
- Access the latest Medicare FFS utilization data to get ahead of the CMS 2023 initiatives
Want to see what this data looks like for your specialty group? Contact Anne Brandner (abrandner@tha.com) to schedule a demo.
