Dobson|DaVanzo’s Data Analytics for Medicare Episode-Based Payment Models
Tuesday, March 30, 2021 | by Randy Haught
Using CMS Innovation Award Data, Dobson|DaVanzo is helping physicians and physician group practices “deep dive” into the complex world of MIPS VBP cost efficiency measures by dissecting risk-adjusted Medicare spending during episodes of care for 18 medical conditions/surgical procedures by clinical theme, type of service, and episode period (pre-, intra-, and post-trigger periods) compared to peer-group benchmarks. This allows providers to easily identify areas for improvement. Our monthly and quarterly data updates provide timely information that allows providers to continually monitor their performance trend overtime.
Radiation Oncology Models of Care: Savings for Providers
Wednesday, October 30, 2019 | by Randy Haught
On July 18, 2019, the Centers for Medicare and Medicaid Services (CMS) proposed a payment model that would make prospective episode-based payment for a list of specified professional and technical radiation therapy (RT) services furnished during a 90-day episode to Medicare fee-for-service (FFS) beneficiaries diagnosed with one of 17 cancer types. This issue brief - the third in our series of "Radiation Oncology Episodes of Care"- shows that the newly proposed CMS payment model may present savings opportunities for radiation therapy providers.
Radiation Oncology Model Episodes of Care: Cost Differences Across Treatment Modalities
Monday, October 14, 2019 | by Randy Haught
CMS proposed a prospective payment model that would pay participating hospital outpatient departments (HOPD) providers and freestanding radiation therapy centers for radiation therapy (RT) episode-based payment for a list of specified professional and technical RT services furnished during a 90-day episode to Medicare fee-for-service (FFS) beneficiaries diagnosed with one of 17 cancer types. Providers will be paid a single rate for each specific cancer type regardless of the treatment modality (i.e., stereotactic radiosurgery, intensity-modulated radiotherapy, conventional external beam, intraoperative radiotherapy, proton beam therapy, or brachytherapy) selected for the patient. Technical component providers that will be subjected to the Radiation Oncology (RO) payment model will need to determine how to achieve a 5-percent savings, which is CMS discount from average historical spending. One option will be to assess the clinical appropriateness and cost effectiveness of the treatment modality used during the episode. This blog is the second in the multi-series of blogs titled "Radiation Oncology Episodes of Care" and examines the cost differences across the various treatment modality options and their impact on episode spending.
Radiation Oncology Model Episodes of Care: Analyzing Medicare Spending
Monday, September 30, 2019 | by Randy Haught
On July 18, 2019, the Centers for Medicare and Medicaid Services (CMS) proposed a payment model that would make prospective episode payments to hospital outpatient departments (HOPD) and freestanding radiation therapy centers for radiation therapy (RT) episodes of care. The model will be mandatory for a sample of RT providers and suppliers and is specific to core-based statistical area (CBSAs), which have not yet been determined. Medicare would pay participating providers and suppliers a site-neutral, episode-based payment for a list of specified professional and technical RT services furnished during a 90-day episode to Medicare fee-for-service (FFS) beneficiaries diagnosed with one of 17 cancer types. This blog is the first in the multi-series of blogs titled "Radiation Oncology Episodes of Care" and takes a look the historical Medicare payments for radiation therapy.