Transparency, c/o Pennsylvania Avenue
On July 30, CMS Administrator Seema Verma spoke at the Blue Button Developer Conference at the White House and announced a number of policy developments to highlight and celebrate the 54th birthday of the Medicare program. We focused on the following statement:
“To make it easier for providers to participate in risk-based contracts, and to ensure that they can effectively manage spending, providers need to have data on all their patients to understand how they are moving through the healthcare system and using services.” S. Verma
We agree! And, in fact, we believe that providers participating in risk-based contracts should demand to have data on the cost and clinical specifics of all the elements of the care that’s been provided to patients for which they are financially responsible.
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Administrator Verma went on to recount recent developments that allow CMS to share claims data with ACOs through its Beneficiary Claims Data API (BCDA) which will eventually supplant the Claim and Claim Line Feed (CCLF) currently provided to ACOs participating in the Shared Savings program.
“Earlier this year at HIMSS we announced the Beneficiary Claims Data API. This API is an improved way for CMS to share claims data with ACOs. It’s a key first step in enhancing data sharing to drive value-based care and increase participation in new payment models.”
This is exciting! FRG has experience working with clinicians who are financially accountable for the total cost of care and are able to review total cost of care analysis in the context of diagnostic history data.
Follow the link below to read our full article: Transparency c/o Pennsylvania Avenue.
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Welcome to AccuReports® Basic Training!
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AccuReports® Basic Training is a one-hour web-based training course that introduces new users to the system's layout and interactive features. Participants learn how to use AccuReports® to monitor trends in the financial performance of service funds.
The course has five lessons, once a lesson is completed, finish each knowledge check to earn a certificate!
To sign up for a training visit: https://frgsystems.com/training
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To schedule an in-depth training session or learn more about AccuReports® by FRG, email: info@frgsystems.com.
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AccuReports® Version Six Release
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What's new, what's provided?
FRG is proud to announce the release of AccuReports® v6 to its Enterprise Report Distribution Service customers effective October 1, 2019. Site Sponsors are invited to set their own upgrade date before November 15, 2019, and FRG will migrate any remaining customer sites on December 1, 2019 automatically. The upgrade enhances the user experience at no additional charge.
What’s new? The changes FRG has made to the AccuReports® user experience are subtle: v6 leverages the same look and feel that users of v5 found intuitive.
Users will notice that report names have been changed to align more consistently with their contents, and order forms now allow multiple simultaneous selections and support saving selection sets.
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Early adopters report that these features have made the system easier to use and faster to explore for opportunities:
Reports have not changed their position on the menu, and hovering over the new report label shows the v5 report name.
Navigation assistance can be requested via live chat or by emailing or calling the FRG Help Desk at (888) 466-1025 x1.
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October opens the season when we begin wrapping up the year and getting ready to start again. Thinking strategically as the fourth quarter unfolds helps us to finish up strong and build plans to hit the ground running when the new year arrives.
October too brings Halloween's ghouls and excitement. We fear sugar-fueled ghouls, and, after taking it all in, we say BEWARE of the trickery of outlandish goals too! Lofty initiatives can be thrilling, but they can also petrify the individuals in your organization who are tasked to carry them out in the dark. Worse, if your organization is haunted with tales of falling short in the past, a false charge can make zombies of your team. Pitchforks and torches!
Prudence in the dark means setting a direction and then defining the steps that will help you generate momentum. Decide to make each step, and move steadily, carefully and calmly. Use whatever you can to light the way, and keep moving.
IPAs and MSOs in risk contracts face uncertainty in premiums (boo!), utilization (eek!) and many of other factors (ahh!). Luckily, simply cultivating good habits for managing assigned membership panels is the pathway to the morning sun.
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Which goals are practical? That depends on the context of the organization and the character of the membership itself. We believe you can achieve tangible results by systematically analyzing claims data (after you put fresh batteries in your flashlight).
Know your trends and outliers. Watch for trouble in utilization factors like emergency room visit frequency and inpatient cost per thousand. Review your per member per month costs regularly: by specialty, by location, and by rendering provider. With each step, you're building good habits of disciplined approaches to performance review for your members and your physicians. Then follow up.
Don't be spooked by shadows of predictive analytics, machine learning, and myriad other tantalizing promises. These are all still in various evolving stages of practical utility, and their prices are shocking.
Instead, once you have made good use of the information available in your claims and begun enhancing your organization’s utilization of this data, focus on implementing new operating strategies. Then repeat the claims analysis. The foundation you build will be invaluable for whichever direction you choose to bravely go next.
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