By: Sampath Kumar  Apr. 01, 2021

Mount Carmel East in Columbus, OH, reported a CMS Value Based Purchasing (VBP) adjustment factor of 0.994 in the year 2021, which could result in an estimated penalty of $450,415. 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 Mount Carmel East Hospital during the period was 1/10. Dexur is an approved purchaser of CMS Medicare claims data and based on our simulator, we estimate that Mount Carmel East Hospital can avoid VBP penalties by reducing MSPB Cost by 6%.

By: Neha Thomas  Jul. 15, 2020

Dexur’s analysis of medicare claims of hospitals within a 10-mile radius of Columbus, Ohio, showed that Mount Carmel East, Mount Carmel St. Ann's, and OhioHealth Riverside Methodist Hospital had the best value outcomes over a 90 day episode for Renal Failure. 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 OhioHealth Medicare ACO and The Ohio State Health ACO, 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 683: Renal Failure with Complication or Comorbidity (CC), to adjust for complications and comorbidities.