NAACOS/IAC Episode Spending Report 

The Center for Medicare and Medicaid Innovation (CMMI) recently announced its strategy to better integrate specialist physicians into Medicare value-based payment models. In the short run CMMI plans to share “enhanced specialty care performance data to give population-based model participants the ability to compare quality and costs of procedural or acute episodes of care, as well as better information on specialist performance.” CMMI has not provided details about what data they will share or when the data would be available. 

To give you a head start, NAACOS and the Institute for Accountable Care are offering episode spending reports to all member ACOs. The reports are based on 2021 spending for each ACO’s attributed beneficiaries grouped into 34 BPCI Advanced 90-day episodes. The reports provide aggregate results for each bundle by type of service along with a state-level comparison group. The episode reports will show your ACOs: 

1. The volume and average spending for each 90-Day BPCI clinical episode for your ACO’s attributed beneficiaries in 2021.
2. The relative ‘efficiency’ of the episodic care your beneficiaries received as indicated by the observed-to-expected ratio. This measure uses risk-standardized episode spending.
3. Per-episode spending for major categories of service such as skilled nursing and hospital readmissions for each episode.
4. Comparisons to your state’s average episode spending. 

Access your ACO’s free report. 

Get instructions on using your ACO’s episode report. 

Watch our recent webinar to learn how to use your ACO’s episode report. 

The Institute for Accountable Care offers a variety of episode of care analytic services including reports with provider-level episode spending detail that can be performed under a separate agreement. More information is available or contact us at [email protected]