Skip to main content

Illuminate your CMS Medicare quality program with an analytics-first strategy

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.


Popular posts from this blog

Unlock the Potential of Value-based Payment

A common misconception in healthcare practices: Organizations can quickly reap the benefits of value-based payment transformation. To launch a successful value-based payment program , practices must implement a variety of foundational pieces. It may take time, resources and data before a practice can successfully engage in VBP. In this blog, we'll cover what goes into VBP and its potential benefits. We'll also dig deeper into practice advancement strategies and how they can help you achieve your practice goals. What goes into VBP? Many practices want to implement VBP because of its payment structure and return on investment. Yet, they might not consider how to nurture a successful VBP program in their organization. It starts with a gap analysis regarding people, processes and technologies. It’s important to celebrate what is working well and intervene where improvement can be made. Successful VBP starts with the practice team. There are many perceptions vs. realities that exist

What is the purpose of a Community Health Assessment?

The purpose of a Community Health Assessment goes beyond achieving state requirements or receiving accreditation. If you're a local health department, you may be interested in finding ways to push your CHA data further to more easily identify ways to improve health equity and community outcomes. Focusing only on submission can be counter-productive to the community outcomes you want to achieve. In this blog, we'll give you an overview of the importance of conducting a CHA. Plus, we'll provide you with key information you can use to reset your workflow and rethink your processes. Why you need to complete a Community Health Assessment Certain states require a CHA because it provides a systematic review of a community's health status and essential data and information regarding the health of the community. Specifically, the New York state Department of Health writes, "Community health assessment is a fundamental tool of public health practice. Its aim is to describe