A new approach to data-driven decision making  Healthcare reform initiatives, driven by government, healthcare providers, and payers, are  shifting the focus of care delivery and payment from individual points of service to the whole patient and entire populations. This transition from “volume” to “value” (or population health) requires a mindset change for hospitals, health systems, and other providers. It necessitates an expanded perspective that encompasses the full spectrum of care for patient populations—from primary to post-acute services—to improve health and outcomes while reducing costs. Download Now

"Shock and awe" were words that many of our clients used when they received their Bundled Payments for Care Improvement (BPCI) "mock" reconciliation data from the Centers for Medicare and Medicaid Services (CMS) in early May. Some were dismayed at the significant reduction in financial surpluses from those that were expected, while others were alarmed by several apparent policy changes that have been implemented without notice and after contracts were signed. This article will discuss what we expected to see, what we actually saw, what we see as the consequent effects on reconciliation, and where we believe policy changes must be forthcoming. Download Now

By exploring the regional variations in Medicare payments for 90-day episodes of care (those beginning with a hospitalization that also includes post-acute care), this report provides key findings from an analysis on four different clinical episodes/areas of care: acute myocardial infarction, congestive heart failure, pneumonia and major hip and knee joint replacements. Download This White Paper

The Centers for Medicare and Medicaid Services (CMS) is allowing providers that are already participating in the BPCI program to evaluate expanding their participation to additional episode families. This article provides a structured approach to those providers for analyzing and evaluating new episode families for inclusion in BPCI. Download This White Paper

An overview of the Bundled Payment for Care Improvement, citing the challenges experienced by both participants and CMS, and sharing lessons learned by New York-Presbyterian Hospital and its data analytics partner, DataGen. Download This  Case Study

Contrast in decision points between two hospitals, both participating in the "Major Joint Replacement" episode family. Download This White Paper

A look at the recently released methodology for computing the target prices for the Medicare Bundled Payment for Care Improvement (BPCI) program. Download This White Paper