In previous posts in our Six Steps to Bundled Payment Success series, we detailed why opportunity assessment, preferred provider network development, a simple care management process, and real time patient tracking are essential steps to success in bundled payment programs.
Today, in the fifth and penultimate step, we are going to discuss claims data analytics. Having the ability to interpret and analyze the data you get from claims is essential to success because once you understand the historical performance of your bundled payment program based on claims, you can determine and measure key metrics for improvement.
To gain access to your claims data, you will first need to submit a Data Use Agreement (known as a DUA) to CMS. CMS makes claims data available month to month, and then delete those files after 30 days. (Learn more about monthly files from CMS here.) The amount of raw claims data delivered can be overwhelming. In the face of this much data, a software solution for data storage, processing, and analytics isn’t just nice to have—it’s a necessity.
Archway Analytics is an easy-to-use analytics platform that makes management of your bundled payment program simple by letting you access claims data reports online. Archway Analytics includes monthly performance reporting, state and national benchmarking, bundle selection analytics, and more. Dashboards show highlights of your program’s overall performance such as post-acute care discharges, SNF length of stay trends, readmission rate, and total program volume.
An analysis of historical data from claims can often provide insights into how costs have been incurred in the past. These insights can inform your decisions as you manage your bundled payment program. However, claims data is too slow to truly manage performance in real time, since data is only delivered months after the conclusion of an episode. In our next and last post in this series we will discuss how at Archway we integrate claims data analytics with real time data to create an integrated dashboard to assess current program performance.
Please contact us at firstname.lastname@example.org if you have any questions about claims data analytics or if you would like to schedule a demo of Archway Analytics.