By: Debasish Choudhury  Mar. 30, 2021

St. Mary’s Medical Center, Grand Junction, CO, reported a CMS Value Based Purchasing (VBP) adjustment factor of 0.9959 in the year 2021, which could result in an estimated penalty of $217,694. 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 St. Mary’s Medical Center during the period was 0/10. Dexur is an approved purchaser of CMS Medicare claims data and based on our simulator, we estimate that St. Mary’s Medical Center can avoid VBP penalties by reducing MSPB Cost by 6.5%.

By: Barsha Nandy  Aug. 07, 2020

Dexur’s analysis of medicare claims of hospitals within a 25-mile radius of Huntington, WV, showed that St. Mary's Medical Center had the best value outcomes over a 90 day episode for Sepsis, followed by Cabell Huntington Hospital. Dexur’s value analysis tracks a patient’s episode of care from the date of admission for 90 days, including the index hospitalizations, rehospitalization, home health, nursing home, and ED costs. The total cost of care data helps patients make appropriate choices and helps local ACOs, such as MHC Accountable Care Organization, LLC, make appropriate referrals choices. The analysis was risk-adjusted, for alive and non-hospice patients and was done at the DRG level, specifically DRG 470: Major Joint Replacement or Reattachment of Lower Extremity without Major Complication or Comorbidity, to adjust for complications and comorbidities.