Market position is a moving target, and COVID-19 made that target even more unpredictable. The patients who walked through the doors at hospitals, doctor’s offices and surgery centers pre-pandemic are different from the ones coming through them now. “The rising acuity of patients coming back is just much more complex, much more fragile,” notes a recent Sg2 forecast of service line trends. “Fluctuating volumes and inconsistent surges have made planning really difficult.” In this environment, hospital leaders must ask three key questions, which are listed below, with answers related to four service lines: cardiovascular, neurology, cancer and orthopedics. Service line growth three must-ask questions 1. What does the market look like today? Hospitals and ambulatory surgery centers in New York state have a tremendous advantage when it comes to understanding their market position. They have access to the Statewide Planning and Research Cooperative System , a core data set that allows facil...

The Hospital Inpatient Prospective Payment System proposed rule for federal fiscal year 2024 includes a change to the rural wage index calculation that has the industry buzzing because it would affect all hospitals – rural and non-rural alike. If finalized, CMS will calculate each state’s RWI with data from rural hospitals and reclassified hospitals, even if those facilities are not rural geographically. As HealthLeaders notes , CMS’ approach since FFY 2020 has been to exclude reclassified hospitals from the rural floor calculation if they were not physically rural. Why the change? Who stands to lose or gain? And what other changes should hospitals watch for? What is the rural wage index? With the FFY 2024 rule, CMS proposes to reverse its exclusion of hospitals redesignated as rural from the RWI calculation. DataGen Senior Healthcare Data and Policy Analyst Jacob Orsini notes that hospitals can reclassify if they are either near a rural area or have a patient population with enough...

CMS’ Bundled Payments for Care Improvement Advanced program will soon kick off a two-year program extension through 2025. Model Year 7 (Jan. 1 - Dec. 31, 2024) will be the first time that current participants (acute care hospitals and physician groups) can update their episode of care selections since 2020. MY7 is also only the second time since BPCIA launched (2018) that CMS will allow new providers to join. Applications were due May 31, 2023. Whether you’re a new applicant or a current participant looking to update your episode selections to improve results, it’s never too early to prepare. BPCIA participants take on immediate full risk. This makes it critical to choose episodes that present the greatest savings, incentive and quality improvement opportunities. Episode selection — An art and a science For optimal BPCIA episode selection, providers must analyze their performance from the historic baseline period and design their clinical effectiveness strategies accordingly. It’s impo...

Strategic growth requires knowledge of how key healthcare industry drivers impact your market. Understanding factors such as population demographics, economics and competitors in the marketplace enables you to make sound decisions about how and where to provide care. With so many global pressures on healthcare, it’s important to remember a crucial industry principle: healthcare is local. Better data ensures your local lens is as clear as possible. Assess your data capabilities How you assess your strategic planning data mirrors how you should assess your market: start from the inside out, maximize the resources you have, and identify and fill the gaps. A few key questions include: Which data sets already deliver strong service line insights? How can we leverage this data to identify more savings, growth and care redesign opportunities? What data is needed to make expansion decisions related to patients, services, settings and provider partners? For New York hospitals and ambulatory sur...

A new data remediation project was discussed at a May 17 DOH forum for all providers that submit data to the Statewide Planning and Research Cooperative System. SPARCS plans to go back through data submitted for inpatient and emergency department cases since 2016 and validate that the injury, cause and place settings are complete and accurate, as required by the guidelines released at the end of April. DOH said that in the next two weeks, it will generate a list of claims that need reconciliation. Each hospital will need to go through records from 2016 to the present and update them to meet the new SPARCS requirements. The requirements are contingent for each year, meaning 2016 has its own set of data, 2017 has its own set, etc. Hospitals eagerly await details, as a remediation project like this could pose many challenges. Some hospitals have changed billing systems and, as a result, may not have access to records that far back. In addition, the medical record notes may not have comple...

Survey results are meaningless without actionable insights. And when the highest levels of quality care and accreditation are on the line, actionable survey results are an absolute must for your hospital. The Agency for Healthcare Research and Quality’s Surveys on Patient Safety Culture™ (SOPS®) suggests you collect the right data from the right people at the right time. Response rates must be high and survey answers meaningful. But these recommendations make SOPS a resource-heavy project. Cumbersome and time-consuming, key insights can be overlooked, and it can be hard to develop action plans to enhance patient and worker safety efforts, especially across two-year survey intervals. It doesn’t have to be that way. Start your SOPS process off right with these tips, including support from the right survey administration partner: DataGen . 1. Make strong, early survey decisions. AHRQ states a 60% response rate is required to obtain an accurate representation of the culture of safety in yo...

Did you notice a large rejection rate when submitting your Statewide Planning and Research Cooperative System data this month? That’s because the New York State Department of Health quietly released an updated SPARCS data set for injury, cause and place codes on April 27 – just four days before the month’s end. More than 10,000 diagnosis codes require a cause of injury. These new updates add a dozen additional diagnosis codes with this requirement. There are more than 2,200 cause of injury codes that require a place. The updated SPARCS dataset added a couple hundred to that. If your team submitted SPARCS data for the end of the month, your SPARCS coordinator is likely making a lot of adjustments to fix the rejections. With DataGen’s UDS platform, your team wouldn’t be bogged down with SPARCS rejections. Our web-based software automates formatting, syncing, error sweeping and submission to SPARCS . That includes the pesky rejections resulting from the updated injury, cause and place co...