CMS releases 2nd CJR data feed — It's time to analyze strategies

Practice Management

In October 2016, CMS released the second data feed of the Comprehensive Care for Joint Replacement Model, offering a broader picture of complete claims data for the second quarter of 2016.

Back in September 2016, Kelly Price, vice president and chief of healthcare data analytics at DataGen, a Rensselaer, N.Y.-based healthcare data analytics and policy firm, shared insights on the first data feed, which encompassed episodes beginning in April, May and June.


DataGen's team analyzed the two data feeds of 57 individual hospitals, finding 3,660 episodes in Q2 2016.


Unlike the initial feed, which didn't offer a full set of all claims in the episodes, the second feed includes a refresh of claims for April, May and June episodes in addition to claims for July, August and September episodes. Upon analysis, DataGen reports the second data feed comprises a relatively complete set of claims for Q2 2016 episodes.


"Now folks can start to compare themselves, for those first three months of episodes, to their targets and see if the strategies they've been implementing are having the impact that they hoped," says Ms. Price.


The second data feed matched Ms. Price's expectations, with a 75 percent increase in episode counts for episodes staring in June.


When comparing the first feed for April episodes to the new feed, Ms. Price points out average episode spend increased 15 percent. The average episode spend for episodes beginning in May rose by 40 percent between the two feeds and 75 percent for June episodes. She attributes these jumps to completion of home health claims and an increase in readmissions.


One CJR strategy involves discharging patients with home healthcare as opposed to sending them to SNFs. Although no evidence pointed to changes in the number of patients discharged to SNF, the average SNF length of stay decreased by 20 percent, says Ms. Price.


Of the hospitals analyzed, 75 percent saved money under the target, and 25 percent ended over target. Aggregate savings of the 57 hospitals came in 6 percent under target.  


Equipped with deeper data, Ms. Price recommends hospital leaders reflect on first-quarter strategies and determine whether their strategies proved effective.  


"There were many hospitals that didn't have strategies in place in the first or second quarters. Now, [hospitals can strategize] with solid numbers behind them," Ms. Price says.


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