Dexur’s analysis of medicare claims of hospitals within a 10-mile radius of New York City, NY, showed that Hospital for Special Surgery, Lenox Hill Hospital, and NewYork-Presbyterian/Weill Cornell Medical Center were the most cost-efficient hospitals over a 90 day episode for Spine Surgeries. 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 NewYork Quality Care, FamilyHealth ACO, LLC, Alliance for Integrated Care of New York, LLC, and HHC ACO, make appropriate referral choices. The analysis was risk-adjusted, for alive and non-hospice patients and was done at the DRG level, specifically DRG 460: Spinal Fusion Except Cervical without Major Complication or Comorbidity, to adjust for complications and comorbidities.

By: Yosh Thomas  Oct. 27, 2020

Dexur analyzed Medicare Claims data to calculate the Medicare Spending per Beneficiary (MSPB) cost for hospitals in the New York tri-state area for Spine surgery and found a wide disparity among hospitals in each sub-area such as Manhattan, Long Island, New Jersey, and Connecticut. MSPB is 25% of the weighting for the CMS Value-Based Purchasing (VBP) programs.

By: Barsha Nandy  May. 14, 2020

Dexur’s analysis of medicare claims of hospitals in New York City showed that Hospital for Special Surgery, Lenox Hill Hospital & NYU Langone's Tisch Hospital had the lowest cost of care over a 90-day episode for Hip & Knee Replacement. 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 New York Quality Care, Family Health ACO, Community Care of Brooklyn, Richmond Quality, The Physicians Alliance, Alliance for Integrated Care of New York, and HHC ACO to make appropriate referrals choices. The analysis was risk-adjusted and was done at the DRG level (specifically DRG 470: Major Joint Replacement Or Reattachment Of Lower Extremity Without Major Complication Or Comorbidity (MCC) to adjust for complications and comorbidities.

By: Saparja Nag  Dec. 04, 2017

An analysis by Dexur estimates that 57.5% of joint replacement surgeries are total knee arthroplasty (TKA) cases that could be shifted to outpatient procedures under new CMS guidelines. Effective on January 1, 2018, TKA will be removed from the inpatient only list (IPO) as announced by the Department of Health and Human Services on November 13, 2017. TKA consists of DRG-469: major joint replacement or reattachment of lower extremity with MCC and DRG-470: major joint replacement or reattachment of lower extremity without MCC. The below table & chart based on the most recently available data from Medicare shows how many TKA procedures could be potentially shifted to outpatient.

By: Jeffrey Maser  Nov. 22, 2017

In another Dexur article, we addressed the connection between physician discharge volume and quality metrics. We found that although volume alone does not necessarily imply quality, these two factors have a strong positive correlation. Therefore, it is still valuable to understand which physicians in an area account for a large portion of the community's healthcare. Similarly, it is valuable to understand which hospitals account for high percentages of a community's discharges.