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BPCIA: 4 fast facts for a successful Model Year 7 kickoff

BPCIA: 4 fast facts for a successful Model Year 7 kickoff  Participation in Model Year 7 launched on Jan. 1, 2024, with the first few months being a critical time for providers. New Bundled Payments for Care Improvement Advanced Model (BPCIA) participants got their footing, and continuing participants were able to change their clinical episode service line groups for the first time since 2020.  If you’re a provider participating in this model, read on for a BPCIA refresher and four fast facts for starting MY7 right. We’ll also cover core analytics activities to support your clinical and operational success.   4 Fast facts on BPCIA Model Year 7  1.   Focus on clinical episodes and episode volume  Before MY7 began, providers used historic baseline data provided by CMS to evaluate which CESLGs they would go at risk for, ensuring there would be sufficient episode volume. Large episode volume (100 episodes/year or more) reduces random variation and helps protect providers from financial ris

Avoid SPARCS Compliance Risks: 3 Deadlines to Know Now

Third quarter Statewide Planning and Research Cooperative System deadlines are rapidly approaching! It’s more important than ever for hospitals to focus on meeting DOH requirements for SPARCS compliance.  In this blog, we'll help you understand what you need to focus on right now to ensure you meet New York state SPARCS data submission deadlines. Read on to learn which data will soon be delinquent, what’s at risk and which target dates hospitals must hit next.  March and April SPARCS compliance deadlines  A hospital’s quarterly SPARCS submission isn’t “done” until it is submitted error-free. DOH publishes SPARCS Audit and SPARCS Compliance Reports to help hospitals keep track. Weekly audit reports document the number of discharge claims a facility submits to the SPARCS data warehouse versus those accepted. Claims with errors are rejected.   The state monitors error resolution through monthly compliance reports. Hospitals with outstanding SPARCS errors receive three warnings before

Navigating the Impact of Medicare Cuts on Hospital Providers

Federal legislative and regulatory measures enacted since 2010 have fundamentally altered Medicare provider payments — and consequently, the operational landscape for hospitals across the United States. As part of an ongoing dialogue on health policy reform and fiscal strategy, it's crucial for hospital administrators and healthcare professionals to understand the breadth and depth of these payment adjustments.  That's why DataGen released the Enacted Medicare Cuts Analysis as part of our legislative analyses suite, which is intended for advocacy purposes only.  We looked at the extent to which hospitals have been impacted by existing Medicare provider payment cuts that Congress has enacted to achieve Medicare payment policy and/or long-term deficit reduction goals. The impacts shown in this analysis include the major cuts enacted since 2010.  In this blog, we'll cover the enacted legislative cuts, enacted regulatory cuts and quality programs analyzed in the Enacted Medica

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

SPARCS compliance: How it can impact your Certificate of Need applications

Did you know that incomplete SPARCS data can delay Certificate of Need applications — all because of failure to stay within New York state SPARCS compliance? In this blog post, we’ll go over the importance of SPARCS compliance and its potential impact on your market growth. What is the Certificate of Need process? New York's CON process “governs establishment, construction, renovation and major medical equipment acquisitions of health care facilities, such as hospitals, nursing homes, home care agencies, and diagnostic and treatment centers.” According to the New York State Department of Health , its objectives are “to promote delivery of high quality health care and ensure that services are aligned with community need” by providing DOH “oversight in limiting investment in duplicate beds, services and medical equipment which, in turn, limits associated health care costs.” 3 ways being out of SPARCS compliance can harm your growth If you don’t satisfy SPARCS requirements, your Artic

What to know before MCP model participation decisions

CMS will select participants for the Making Care Primary model soon. Once accepted, primary care practices will have to decide whether they’ll join the MCP model. This is no easy decision. In this blog, we’ll cover what primary care practices should consider before joining MCP, focusing on readiness and model design. Learn what you need to know before officially joining MCP and beginning the onboarding process, from April to July 1, 2024. MCP model track eligibility When organizations applied to MCP in November, they selected from three tracks depending on their value-based care experience. Track 1 was designed for practices with little to no VBC experience. This was done to encourage small and rural practices to participate. However, participants starting in Track 1 will eventually move to Tracks 2 and 3 over the performance model years. When CMS accepts practices, providers may be found ineligible for the track for which they applied. In these cases, they may be eligible for, and CM

What is a Community Health Needs Assessment? 4 Tips to Start

Hospitals typically conduct a  Community Health Needs Assessment  to comply with state requirements or to maintain 501(c)3 status. However, emerging trends around health outcomes and health equity have sparked organizations to update and better align their CHNA processes toward highlighting community needs, equity, population health concerns, service access, affordability and quality. In a research study,  The National Library of Medicine  found that "Social determinants of health impact 80% of health outcomes from acute to chronic disorders, and attempts are underway to provide these data elements to clinicians." Because of the short- and  long-term effects of SDOHs , it's important that hospitals assess community needs. This way, they can find solutions to improve quality of life, identify underserved populations and establish connections with the community. What can your organization do to revamp its CHNA process to focus on community needs, equity, care access, afford