Project Summary: Testing Bundles of Care Analytics to Improve Quality and Lower Costs
Category: Bundled Payments, Payment Reform
Background: HCI3’s multi-tiered analytics system starts with analysis of individual patients and the episodes they trigger, then rolls up the results to the population level, allowing for both individual drill-downs and estimation of overall trends.
At each level of analysis, it is possible to distinguish between costs associated with typical or necessary care vs. costs resulting from unnecessary or inadequate treatment.
Objectives: Analysis of CO APCD data had two prongs:
1) Test the applicability of the cost-of-care metrics to Colorado data
2) Test the applicability of certain quality metrics (i.e. NQF-endorsed rates of potentially avoidable complications for certain chronic conditions and acute medical events)
Data Analyzed: All claims data (inpatient, outpatient, professional, ancillary) from 2009-2012.
Results: HCI3 was able to demonstrate similar patterns of variation in price, frequency, and mix per episode that they have observed in other parts of the country. Additionally they established that the analytics are applicable to APCD data and to support payment reform projects in CO.