DataGen launches new BPCIA tools to map changes in episode participation

Interactive tools show changes across clinical episode categories and geography, giving provider organizations insight into how the program is maturing

ALBANY, N.Y., June 3, 2020 /PRNewswire/ -- DataGen, a leading healthcare data analytics and policy firm, has launched two free online tools to give provider organizations insight into national and regional episode participation trends in the Bundled Payments for Care Improvement Advanced program. The interactive tools map shifting BPCIA episode participation from model years 1 and 2 to model year 3 by clinical episode category and by geography.

DataGen designed the tools to give provider organizations a clearer picture of where their current participation in BPCIA stands related to national and regional trends. Using the first tool, users can select a clinical episode category and compare data from model years 1 and 2 with model year 3. The second tool enables users to enter their city or ZIP code to view data from their Core-based Statistical Area. These regional data show changes in total participants and number of selected clinical episode categories from model years 1 and 2 to model year 3, as well as changes in the top three clinical episode categories.

DataGen released an interactive BPCIA map last year that gave provider organizations visibility into average expenditures at the local and national levels, helping them better assess whether they can be successful under BPCIA.

"We are seeing more participation in BPCIA model year 3 overall," said Alyssa Dahl, DataGen's director of informatics. "With the second enrollment period offered last year, providers who felt unprepared at the onset of model year 1 were likely able to take some more time to get executive buy-in and make the operational improvements needed internally for a model year 3 entry."

"Many of our clients are approaching BPCIA as a good way to 'get their feet wet' in bundled payment programs and start transforming care in anticipation of future mandatory models," said Mike Ilnicki, DataGen's president. "We hope our interactive online tools will help current and future program participants see more of the big picture around how BPCIA participation has evolved and where they would fit into episode participation trends."

The Centers for Medicare and Medicaid Services announced BPCIA as a voluntary episode-based bundled payment model in January 2018; it is set to run until the end of 2023. Broadly, the program is an opportunity for providers to ease into value-based care through practice transformation and visibility into data they would not otherwise have access to. Participating providers can choose from 35 clinical episodes during the application period (31 inpatient and four outpatient). Payments are based on individual practice performance compared to risk-adjusted target prices during a 90-day episode of care that continues after discharge or the outpatient procedure.

The first cohort of BPCIA participants started the program Oct. 1, 2018. The second cohort applied for the program in 2019 and began participation on Jan. 1, 2020.

About DataGen

For more than 20 years, DataGen has been an essential partner to healthcare organizations across the country, illustrating the financial implications of payment policy changes and promoting a pragmatic view of how changes will affect revenue and profitability. DataGen provides data analytic support to hospitals, health systems, state hospital associations and other healthcare groups across the nation as they strive to improve quality, outcomes and financial performance. Drawing on specialized health policy and payment expertise, as well as in-depth understanding of the power of analytics to drive change, DataGen simplifies the complexities of healthcare payment change.


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