By: Sharath joji  May. 03, 2021

Lehigh Valley Hospital-Schuylkill S. Jackson Street, Pottsville, PA, reported a CMS Value Based Purchasing (VBP) Adjustment Factor of 0.9916 in the year 2021, which could result in an estimated penalty of $179,861. Medicare Spending Per Beneficiary (MSPB) accounts for 25% of overall VBP score and is a significant factor in driving VBP payments. MSPB costs include the costs from 3 days before hospitalization, index hospital stays, and 30 days post-discharge. The measure score of the Efficiency & Cost Reduction domain for Lehigh Valley Hospital-Schuylkill S. Jackson Street during the period was 0/10. Dexur is an approved purchaser of CMS Medicare claims data and based on our simulator, we estimate that Lehigh Valley Hospital-Schuylkill S. Jackson Street can avoid VBP penalties by reducing MSPB Costs by 12.9%.

By: Barsha Nandy  May. 14, 2020

Dexur’s analysis of medicare claims of hospitals in Central Pennsylvania showed that Lehigh Valley Hospital, Reading Hospital & St. Mary Medical Center had the lowest cost of care over a 90-day episode for COPD. The episode of care tracks a patient journey from the date of admission for 90 days includes the index hospitalizations, rehospitalization, home health, nursing home, and ED costs. The total cost of care helps patients make appropriate choices and helps local ACOs such as Penn State Health Care Partners and Keystone ACO to make appropriate referrals choices. The analysis was risk-adjusted and was done at the DRG level (Specifically Drg 190: Chronic Obstructive Pulmonary Disease With Major Complication Or Comorbidity (Mcc) to adjust for complications and comorbidities.