Accelerator Overview

Insight to help manage cost and variation associated with CMS-defined and custom payment bundles.

The Bundled Payments Analytic Accelerator enables healthcare provider groups to prioritize strategic initiatives to improve care quality and efficiency across episodes of care—and to support success in bundled payment arrangements. The application surfaces potential opportunities on an individual patient and provider/practice level and helps identify appropriate interventions. The tool supports organizations’ efforts to see and meet the health needs of their patient populations and to gauge the impact of improvement on the organization’s bottom line.

Background & Problem Summary

Bundled payment initiatives attempt to reduce care fragmentation and improve overall quality of care by aligning incentives between all providers—including hospitals, physicians, and post-acute care providers—that touch a single episode of care. Instead of issuing separate payments to each of the participating providers, the payer issues a single payment for the episode of care. To manage costs and overall quality, participating providers need to work closely with any provider that provides services to the patient as a part of that episode.

Data and analytics are critical to help providers manage the complexity of coordinating and improving care—and to succeed in these new payment models. However, many organizations lack access to timely, accurate data and advanced analytic capabilities that would allow them to see opportunities across the network, predict their impact, and take action to ensure efficiency and quality across the episode of care.

Benefits & Features

Understand your current performance and risk.

The application provides an understanding of revenue-at-risk compared to CMS-mandated reimbursement models.

Identify your opportunities to improve.

The application allows users to evaluate variation in cost and revenue-at-risk to identify the bundles with the biggest opportunities for improvement. Users can gauge the potential impact of reductions in variation on select bundles or identify bundles to go at-risk for by evaluating cost and variation in each of the CMS-defined or custom episodes of care.

Self-serve actionable insight.

The accelerator supports root-cause analysis of variation in care bundles. Users can look across specific locations, settings, providers, and utilization trends to find actionable insights.