By: Sampath Kumar  May. 18, 2021

Aultman Hospital in Canton, OH, reported a CMS Value Based Purchasing (VBP) adjustment factor of 0.9919 in the year 2021, which could result in an estimated penalty of $411,674. 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 Aultman Hospital during the period was 0/10. Dexur is an approved purchaser of CMS Medicare claims data and based on our simulator, we estimate that Aultman Hospital can avoid VBP penalties by reducing MSPB Cost by 10.4%.

By: Barsha Nandy  Jul. 30, 2020

Dexur’s analysis of Medicare claims of hospitals within a 10-mile radius of Buffalo, NY, showed that Mercy Hospital of Buffalo, Kenmore Mercy Hospital, and Sisters of Charity Hospital had the best value outcomes over a 90-day episode for Sepsis. 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 Optimum Physician Alliance, 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 871: Septicemia or Severe Sepsis without MV >96 Hours with Major Complication or Comorbidity, to adjust for complications and comorbidities.

By: Neha Thomas  Jul. 30, 2020

Dexur’s analysis of medicare claims of hospitals within a 10-mile radius of Canton, Ohio, showed that Aultman Hospital had the best value outcomes over a 90 day episode for COPD, followed by Mercy Medical Center. Dexur’s value analysis tracks a patient’s episode of care from the date of admission for 90 days and includes the index hospitalizations, rehospitalization, home health, nursing home, and ED costs. Total cost of care data helps patients make appropriate choices and helps local ACOs, such as Integrated Health Collaborative, LLC, make appropriate referral choices. The analysis was risk-adjusted, for alive and non-hospice patients 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.