Analytics

The Institute for Accountable Care conducts research and analysis using Medicare Claims Data accessed through an Innovator Data Use Agreement with the Center for Medicare and Medicaid Services. We have access 100 percent of Medicare Part A, Part B and Part D claims from 2011 through mid-2020. IAC has have a range of analytic services to support ACOs performance improvement which you can download here. If you would like to learn more about our analytic services, contact us at [email protected].

QP Score Contribution by ACO Physician Groups

Congress recently froze the Quality Performance (QP) thresholds required for providers to receive the MACRA 5 percent advanced APM bonus. But, 20 – 30 percent of ACOs in downside risk models still may not qualify for the bonus. We offer a detailed analysis of QP scores for your ACO and physician groups and we conduct scenario analysis to support planning for your facilitate 2022 provider networks. Click here for a summary of our services.

Physician Group Performance Analysis

We build profiles of risk-adjusted spending, utilization and referral patterns of physician practices in your markets. These profiles help you develop performance benchmarks, assess changes in market share and identify groups that your ACO or clinically integrated network could potentially recruit based on their contribution to beneficiary attribution, cost efficiency and clinical quality.

Evaluation of Clinical Management Initiatives

Many groups utilize pre-post analysis to evaluate the impact of care management programs which can be heavily biased by natural changes in health status that occur over time (i.e., regression to the mean). We conduct scientifically rigorous evaluations based on clinically and geographically matched comparison groups that generate statistically valid results that measure the true impact of your programs on spending and utilization.

 

 

Post-Acute Care Network Performance

We profile the performance of skilled nursing facilities (SNF) in your market to support development of preferred relationships with high-quality efficient facilities. We analyze performance based on all of the SNF’s Medicare patients (not just your ACO patients) to provide reliable estimates of spending and quality. We also use MDS/OASIS assessments and can develop risk adjustment techniques that incorporate patient functional status.

Episode Analytics for Hospital and Specialist Care (In-Process)

We use an episode grouper designed specifically for Medicare through a five-year CMS contract to help you identify opportunities to streamline care, reduce complications and identify efficient specialty practices in specific clinical domains. The grouper includes chronic condition episodes, acute medical episodes and procedural episodes and we use it to profile resource use at the patient, provider, population and health system level.

Analysis of Attribution Dynamics

We can identify Medicare patients seen by your ACO’s primary care providers or specialists that are not attributed to your ACO and help you understand which providers are successfully competing for these patients and how. This information will help you develop strategies to increase the “stickiness” of patients to your ACO and grow your attribution.