CMS Medicare Care Quality: How Data Stories Help

Healthcare providers face difficult choices that can pit their number one priority ─ care quality ─ against the need to reduce costs and increase efficiency. Healthcare providers can achieve all of these goals using data analytics.

An analytics-first strategy enables hospitals, health systems and state hospital associations to make data-informed decisions, not best guesses. This proactive approach can illuminate trends and provide real-time insights that are often hidden or seen too late to change outcomes.

Data from your Medicare quality programs tell a compelling story, 24 hours a day, 365 days a year. DataGen uses Medicare impact modeling, expert analysis and visualizations to reveal data-informed narratives about your performance on three CMS programs:

• Value-Based Purchasing (VBP);
• Readmission Reduction Program (RRP); and
• Hospital-Acquired Conditions (HAC) Reduction Program.
  

Do you know your organization’s stories?

The biggest and best tool in your healthcare management toolkit: Data

DataGen data analytics can help you:

• reduce the negative, avoidable impacts of CMS penalties;
• ensure more revenue flows to your organization; and
• forewarn of regulatory impacts that make the difference between positive or negative outcomes for patients, providers and your community.

The DataGen Medicare FFS Quality Suite helps you identify improvement strategies by drawing out projected quality program impacts and performance trends, and enabling deep comparisons.

DataGen can help you monitor your hospital’s national peer percentile rank, foretell future-state revenue and gain more under Medicare quality programs.

Who wouldn’t want to stay ahead of that?

Take a peek at the data insights you may be missing

Each year, CMS adjusts payments for the acute care inpatient hospital setting based on performance in the VBP, RRP and HAC programs. DataGen’s most recent analysis compared these impacts for federal fiscal years 2021 to 2023.*

For RRP in FFY 2023, DataGen estimated a total loss across the country of $320 million due to poor performance on readmission quality measures. The map below shows state-by-state percentage impacts.

FFY 2023 RRP Percent Impact on Base Operating Dollars

*Note: CMS is neither penalizing nor rewarding hospitals for FFYs 2022 and 2023 for VBP due to the COVID-19 pandemic. For the same reason, CMS is not penalizing hospitals for the FFY 2023 HAC program.

Customized data stories at your fingertips

DataGen Medicare FFS Quality Suite enables you to select filters that narrow (e.g., specific facility) or broaden (e.g., market, region, state or nation) your data. Report toggles can instantly shift the data story. Other filters — for example, potential Medicare cuts, condition revenue and estimated impacts — create user-selected granularity and add customized storytelling to reporting.

DataGen’s visualization platform also contains dozens of native reports, so your stories can be interesting and insightful from the start.

Data stories from current CMS headlines

DataGen pools data and insight comparisons from multiple sources, including regulatory, legislative, quality, financial and operations. This allows you to identify and address impacts quickly to improve patient outcomes.

Find out how an analytics-first approach can strengthen your organization’s healthcare management. Reach out to DataGen today.