August 09 2018 By: Benjamin Swails

Beyond episode selections – where to focus now

You made it through episode selections for BPCI Advanced. Now it’s time to decide whether or not to stay in a particular episode before the March 2019 deadline.

Even partnered with a convener, many providers will struggle to project their future performance to determine whether to stay in a particular episode beyond the March withdrawal period. If you haven’t already, it’s time to finalize your strategy for clinical and financial success.

There is no shortage of vendors selling BPCI Advanced episode diagnostics. But before you buy… beware!

Did you know that many diagnostic providers have opted not to invest in replicating CMS’s target pricing? In other words, many vendors may be passing off re-packaged CMS numbers as insights, over-promising based on poor data and simplistic assumptions. By simply re-packaging CMS’s files, these vendors can only tell you how you performed historically. What you really need to understand is how you are likely to perform in the program going forward and to do that you’ll need far more advanced analytics and a deep understanding of CMS’s rules.

Don’t be fooled into choosing a vendor that can’t support you beyond initial episode selections.

Clarify has more recent data on your performance and provides customers with a continuous projection of their bonus or penalty based on real-time target price calculation. You need a clear, actionable understanding of how you’re likely to perform once the program starts. To do that you’ll need the most advanced analytics and a deep understanding of CMS’ rules.

Make sure your vendor has the expertise to power your success. Get your guide to success in our BPCI Advanced Insights eBook.

0 Like