Using the dashboard below, drill down to the particular ACO level that you're most interested in.
Q: What data source is populating this dashboard?
A: This analysis is using the entire Medicare FFS data set from calendar year 2018. The data is broken down at the ACO level. The financial numbers for an Inpatient stay and ICU stay are derived from the 2017 MedPar dataset.
Q: What cost estimates are you using to project potential spend?
A: We are using an average cost for an inpatient stay (with and without ICU services) across 2017 MedPar data for Pneumonia (DRGs 193, 194, and 195).
Q: How do you define your incidence rates?
A: We leveraged the methodology defined in the FAIR Health Brief "The Projected Economic Impact of the COVID-19 Pandemic on the US Healthcare System" for both incidence rate and estimates of IP Stays as well as those seeking medical care.
Low incidence assumes a 20% incidence rate based on attributed population size
Medium incidence assumes a 40% incidence rate based on attributed population size
High incidence assumes a 60% incidence rate based on attributed population size
High Estimate of IP Stays assumes a 20% rate of patients seeking medical care admitted
Low Estimate of IP Stays assumes a 15% rate of patients seeking medical care admitted
Seeking Medical Care assumes a 50% rate of the attributed population size relative to the incidence rate.
Q: What is your calculation for spend?
A: We take the attributed patient population and apply a low, medium, and high incidence rate. From there, we assume a 50% seeking medical care rate and then apply a high estimate and low estimate of IP stays. We then use a roughly 4:1 ratio of IP:ICU stay and apply an average cost based on the MedPar data to get IP Spend, ICU Spend, and Total Spend.
Q: Is this scenario planning exercise meant to have a high precision?
A: No, this scenario planning exercise is meant to provide you with a set of scenarios using a conservative cost estimate. It's highly likely that you could be impacted even more negatively than the numbers in the dashboard show.
Q: How are the risk factors defined in the ACO Overview?
A: The risk factors are the same risk factors we profiled in our last blog and can be seen here.
Should you have any additional questions, please reach out to your main point of contact at CareJourney for more information and/or additional support regarding this analysis. If you do not have a main point of contact at CareJourney, please reach out to jumpstart@carejourney.com.
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CareJourney is a leading provider of clinically-relevant analytics for value-based networks supporting leading payer, provider, and life sciences organizations across the US. We help these organizations achieve their goals by bringing new, high value insights out of expansive population claims data.